Narcolepsy

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• QWhat is narcolepsy?

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  A American Academy of Sleep Medicine answered

  Narcolepsy is a lifelong sleep disorder that makes you feel overwhelmingly tired. Severe narcolepsy can cause sudden, uncontrollable sleep attacks.
  
  Narcolepsy can impact nearly every aspect of your life. Excessive sleepiness or a sleep attack may occur at any time of the day, in the middle of any activity, including eating, walking or driving. Operating a vehicle with untreated narcolepsy can be very dangerous and some states even have laws against it.
   

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• QHow can I cope with narcolepsy?

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  A American Academy of Sleep Medicine answered

  Your doctor may recommend lifestyle changes to help you manage the symptoms of narcolepsy. You will need to keep a consistent sleep schedule by going to sleep and waking up at the same time every day, including weekends. If possible, schedule short, 20-minute naps throughout the day. To increase your energy through the day, try to get regular exercise and avoid using tobacco, alcohol or drugs.

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• QHow is narcolepsy treated?

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  A American Academy of Sleep Medicine answered

  Many doctors prescribe the drug modafinil (Provigil) first for narcolepsy because it is less addictive and has fewer side effects compared to other stimulants. Other medications prescribed for narcolepsy include methylphenidate (Ritalin) or amphetamines.
  
  Selective serotonin reuptake inhibitors (SSRIs) and antidepressants are often prescribed to treat cataplexy and other narcolepsy symptoms, including hallucinations and sleep paralysis. The effects vary depending on the medication your doctor recommends. In severe cases of cataplexy, your doctor may prescribe sodium oxybate.

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• QIs there a cure for narcolepsy?

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  A American Academy of Sleep Medicine answered

  There is no cure for narcolepsy. However, medication and lifestyle changes can help you manage the sleep disorder. It may take some time for a board-certified sleep doctor to find the right treatment plan for you.

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• QHow is narcolepsy diagnosed?

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  A American Academy of Sleep Medicine answered

  A doctor will perform a combination of tests to help determine if you have narcolepsy:

  • In-lab overnight sleep study (polysomnogram): A sleep study requires you to stay overnight at a sleep center so a doctor can observe and measure your sleep. Sensors attached to different parts of your body record your brain waves, heartbeat and other things while you sleep. This test will show if other health conditions, such as sleep apnea, are causing your excessive daytime sleepiness or sleep attacks.
  • Multiple Sleep Latency Test (MSLT): Also known as a nap study, the MSLT measures daytime sleepiness. The test requires you to attempt to take multiple naps at a sleep lab at set times throughout the day. It is used to see how quickly you fall asleep in quiet daytime situations. For each nap trial you are asked to lie quietly in bed in a dark room and try to go to sleep. Most people with narcolepsy fall asleep in an average of three minutes during the MSLT.
  • Hypocretin level measurement: Rarely, the doctor will measure your hypocretin (orexin) levels. Hypocretin is a brain chemical that controls arousal, wakefulness and appetite. People with narcolepsy with cataplexy usually have a lack of hypocretin. Because this exam requires a lumbar puncture (spinal tap) it is rarely used.

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• QWhat are the signs of narcolepsy?

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  A American Academy of Sleep Medicine answered

  If you answer yes to any of the following questions, there is a chance that you have narcolepsy.
  
  Have you had the sudden urge to sleep during the day even though you’re getting enough sleep at night?
  
  Have you fallen asleep while working, eating or speaking with someone?
  
  Have you felt alert after a brief nap but then the alertness quickly changes to sleepiness?
  
  Since narcolepsy is not a common sleep problem, many primary care doctors have difficulty diagnosing the sleep disorder. A board-certified sleep medicine doctor can help make the proper diagnosis. Schedule an appointment with a sleep medicine doctor at an American Academy of Sleep Medicine (AASM) Accredited Sleep Disorders Center.

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• QWhat are the symptoms of narcolepsy?

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  A American Academy of Sleep Medicine answered

  Symptoms of narcolepsy usually begin between the ages of 15 to 25, but they may start at a much younger or older age. The symptoms usually worsen after the first few years.
  
  Narcolepsy symptoms may include:

  • Excessive daytime sleepiness: This is the main symptom of narcolepsy. You may feel tired during the day even though you had a full night’s sleep. This sleepiness is difficult to prevent and may vary over the course of the day. After a brief nap, you may feel alert, but the sleepiness will return after an hour or two.
  • Hallucinations: Some patients with narcolepsy have vivid hallucinations as they fall asleep. They are usually visions that someone or something is present in your bedroom. The hallucinations can feel very real, and trigger feelings of fear or dread. Other common visions may include being caught in a fire or flying through the air. The experiences are mainly visual, although they may also involve the sense of sound, touch, taste and smell.
  • Sleep paralysis: You might lose the ability to move when you are falling asleep or waking up. This usually lasts a few seconds or minutes. This paralysis can be frightening, but it is not associated with an inability to breathe. Sleep paralysis can sometimes go along with hallucinations, which can be especially upsetting.
  • Disturbed nighttime sleep: About half of people with narcolepsy have problems sleeping through the night. You may wake up frequently and have difficulty falling back to sleep.
  • Memory problems: You may have trouble remembering things that people tell you because you were not fully awake at the time. Memory lapses also happen when you are sleepy and doing activities that do not require much thought.
  • Sudden loss in muscle tone (cataplexy): This symptom only occurs if you have narcolepsy with cataplexy.

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• QWhat is cataplexy?

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  A American Academy of Sleep Medicine answered

  Cataplexy occurs when you have a sleep attack that is triggered by a strong emotion. This can happen when you are surprised, elated or even intimate with a partner. You may slur your speech or lose control of your limbs, or you may become completely paralyzed.
  
  Narcolepsy with cataplexy is frequently linked to increased weight, sometimes obesity. It is possible to have narcolepsy along with another sleep disorder, such as sleep apnea or rapid eye movement (REM) sleep behavior disorder. 

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• QDo people with narcolepsy sleep more than people without it?

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  A American Academy of Sleep Medicine answered

  When you add up the total hours of sleep time, people with narcolepsy don’t necessarily sleep any more than those without the sleep disorder. Many people with narcolepsy often have difficulty sleeping through the night because of unwanted awakenings.
• QHow common is narcolepsy?

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  A American Academy of Sleep Medicine answered

  About one in 2,000 people have some form of narcolepsy. However, many people with narcolepsy do not know they have the sleep disorder. Narcolepsy may run in some families, but most cases are not genetic. The disorder is extremely rare in children.

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