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A sleep disorder can affect your quality of life, as sleep is just as important as physical health. Some sleep disorders, like narcolepsy, can cause serious disruptions in a person’s daily routine. The expert staff at Banner Health is here to help treat any sleep disorders to help you live a better life.

What is Narcolepsy?

Narcolepsy is a chronic sleep disorder that causes overwhelming drowsiness during the day and sudden attacks of sleep. People with narcolepsy can find it difficult to stay awake for long periods of time, regardless of the circumstances.

There are two common types of narcolepsy.

Narcolepsy Type 1 can be accompanied by uncontrollable muscle weakness and loss of muscle tone (cataplexy), which happens suddenly while a person is awake. Cataplexy is similar to the muscle weakness that happens during rapid eye movement (REM) sleep at night. Since it causes muscle weakness, it can make people feel like they’re going to collapse and, in rare cases, also causes involuntary muscle movements. Due to these symptoms, cataplexy can be misdiagnosed as a seizure disorder.

People with Narcolepsy Type 1 are more at risk for cataplexy after experiencing strong emotional responses, like stress, laughter, fear or excitement. In mild attacks, the cataplexy can appear as something small, like a drooping eyelid. In more severe cases, people may experience a total body collapse. The duration of these episodes varies, but can last anywhere from a few seconds to a few minutes. The amount of times a person with Narcolepsy Type 1 experiences cataplexy is unique to each individual. Some may experience several cataplexy episodes per week while others may only experience it a few times throughout their lives.

Narcolepsy Type 2 involves the common narcolepsy symptoms, but occurs without the cataplexy.

There is also a third, very rare type of narcolepsy called secondary narcolepsy. Secondary narcolepsy typically results from a brain injury, specifically to the hypothalamus region. This is the region of the brain that regulates sleep.

Narcolepsy is not very common but has recently become more common for unknown reasons. Narcolepsy is a chronic condition, and while there is currently no cure, it can be managed with medications and lifestyle changes.

Factors and Symptoms of Narcolepsy

The exact cause of narcolepsy is unknown. People with Narcolepsy Type 1 typically have low levels of hypocretin, which helps regulate wakefulness and REM sleep. This neurochemical is particularly low in people who experience cataplexy and low levels may be caused by an autoimmune reaction.

In some cases (about 1 percent), genetics can play a role in the development of narcolepsy. Research also shows that there is also a possible association with narcolepsy and exposure to swine flu (H1N1 virus).

Symptoms of narcolepsy can develop over the course of several years, often worsening for the first few years and continuing for life. These symptoms include:

  • Excessive daytime sleepiness
  • Sudden loss of muscle tone (cataplexy)
  • Sleep paralysis, either while falling asleep or waking up
  • Changes in rapid eye movement (REM) sleep
  • Hallucinations as a person falls asleep

In addition to these symptoms, people with narcolepsy may also suffer from other sleep disorders, such as sleep apnea, insomnia or restless leg syndrome.

Diagnosis and Testing for Narcolepsy

Your doctor will take note of symptoms of excessive daytime sleepiness and sudden loss of muscle tone for a preliminary diagnosis.

After this initial evaluation, your doctor may also refer you to a sleep specialist for further evaluation. During your sleep evaluation, your doctor may recommend an overnight stay at a sleep center followed by a daytime nap study (Multiple Sleep Latency Test) for an in-depth sleep analysis by sleep specialists.

Sleep specialists will be able to make a formal diagnosis of narcolepsy by looking at the following:

  • A detailed sleep history, usually evaluated by filling out an Epworth Sleepiness Scale
  • Sleep records of your sleep patterns
  • Results from a polysomnography test
  • Results from a sleep latency test

Looking at this information can help doctors rule out other sleep disorders that can cause excessive daytime sleepiness, such as chronic sleep deprivation, sleep apnea or the use of sedating medications.

Treatment for Narcolepsy

There is currently no cure for narcolepsy. However, treatment options, including medication and lifestyle changes, can help manage symptoms.

Medications that are typically prescribed for narcolepsy include:

  • Stimulants to help you stay awake during the day
  • Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) to help alleviate the symptoms of hypnagogic hallucinations, cataplexy and sleep paralysis
  • Tricyclic antidepressants to manage cataplexy
  • Sodium oxybate to help improve nighttime sleep

If you have narcolepsy, your doctor will work with you to find a treatment plan that is right for your individual needs.

In addition to medication, making small lifestyle changes can help manage narcolepsy symptoms, such as:

  • Taking 20-minute naps during strategic times throughout the day
  • Sticking to a consistent wake and sleep schedule on weekdays and weekends
  • Getting regular, moderate exercise at least 4 to 5 hours before bedtime
  • Avoiding nicotine and alcohol

If you’re driving a long distance, be sure to talk to your doctor about medications that can help you stay awake throughout your drive. Stop for naps and exercise breaks if necessary.

If you are experiencing symptoms of narcolepsy, our sleep specialists can work with you to create an individualized care plan to meet your needs. Talk to your doctor today.