Narcolepsy is a disorder of the nervous system. It results in frequent, involuntary, episodes of sleep during the day. Sleep attacks can occur while you drive, talk, or work.
The cause is unknown. It is thought to have a genetic link. There is increasing evidence that it may be an autoimmune disorder. In this type of disorder the body’s own immune system attacks a part of the brain.
Symptoms usually start during the teenage years. Onset may range from 5 to 50 years old. Symptoms may worsen with aging. They may improve in women after menopause.
- Excessive daytime sleepiness
- Daytime involuntary sleep attacks
- Unrefreshing sleep
- Sudden loss of muscle tone without loss of consciousness (cataplexy)
- Temporary paralysis while awakening
- Frightening mental images that appear as one falls asleep
- Memory problems
Symptoms may be triggered by:
- A monotonous environment
- A warm environment
- Eating a large meal
- Strong emotions
Brainstem—Area of Brain Related to Alertness
The doctor will ask about your symptoms and medical history. A physical exam will be done. If narcolepsy is suspected, you may be referred to a specialist in sleep disorders.
Tests may include:
- Multiple sleep latency test (MSLT)—measures the onset of rapid eye movement sleep, which occurs earlier than normal in narcolepsy
General sleep lab study—often performed the night before an MSLT; helps to rule out other causes of daytime sleepiness by monitoring:
- Brain waves
- Eye movements
- Muscle activity
- Heart beat
- Blood oxygen levels
- Total nighttime sleep
- Amount of nighttime REM sleep
- Time of onset of REM sleep
- Degree of daytime sleepiness
Treatment may include:
- Stimulant medications that increase levels of daytime alertness include:
- Antidepressants—to help treat many symptoms of narcolepsy (eg, cataplexy, hallucinations, sleep paralysis)
Other treatment options include:
- Planned short naps throughout the day
- Counseling to cope with issues of self esteem
- Wearing a medical alert bracelet or pendant
National Sleep Foundation
Better Sleep Council of Canada
Bhat A, El Sohl AA. Management of narcolepsy. Expert Opin Pharmacotherapy . 2008;9(10):1721-1733.
Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet . 2007;369:499-511.
Feldman NT. Narcolepsy. Southern Medical Journal . 2003;96:277-82.
Narcolepsy: new understanding of irresistible sleep. Mayo Clinic Proceedings . 2001.
National Institute of Neurological Disorders and Stroke, National Institutes of Health
Last reviewed February 2009 by ]]>Rimas Lukas, MD]]>
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