Imagine falling asleep in the middle of a meeting or a conversation with a friend. While that might seem strange or hard to believe, for people with narcolepsy, it can be a reality. Narcolepsy is a sleep disorder that can result in unwillingly falling asleep during activities, such as eating, working or even driving.
In order to understand more about narcolepsy, it’s helpful to learn a little bit about normal sleep stages of sleep. When you first fall asleep, you usually enter a stage called non-rapid eye movement (NREM). NREM is divided further into three stages.
During stage one, you’re just starting to fall asleep. It’s usually during this stage when you might experience hypnic jerks. Hypnic jerks are sudden “jumps” that may occur occasionally when you’re falling asleep. As you move to stage two and three of NREM, your brain waves slow and you’re progressing into deeper sleep.
During the night, you eventually progress into to rapid eye movement (REM) sleep. Dreaming usually occurs in this stage of sleep. What can happen to people with narcolepsy is they enter REM sleep without gradually going through the first stages of sleep.
Narcolepsy symptoms include excessive daytime sleepiness, sudden bouts of sleep regardless of the circumstance and sleep paralysis. According to the University of Maryland Medical Center, about two-thirds of people with the disorder also experience an abrupt, temporary loss of muscle control. The loss of muscle tone, which is referred to as cataplexy, may be triggered by intense emotions, such as anger, surprise or laughing.
Another possible symptom is unusually vivid dreams. The dreams occur either as the person is falling asleep or as they are waking up. What makes the dreams particularly frightening is since the person is in a semi-wake state, the dreams seem real.
Although most people may not be familiar with narcolepsy, the condition is not as rare as you might think. According to the National Institute of Neurological Disorders and Strokes, about one in every 3000 people in the United States have the condition, although it’s often underdiagnosed.
Symptoms tend to start in childhood or the teen years, but the disorder can also develop later in adulthood. It’s not surprising that the narcolepsy can interfere with daily activities and make work and school challenging. People with narcolepsy can also have additional sleep disorders, such as restless leg syndrome or sleep apnea, which creates even more problems sleeping.
Cause of Narcolepsy
Researchers have not identified the root cause of narcolepsy. But according to the Mayo Clinic, studies have indicated that people with narcolepsy with cataplexy tend to have low levels hypocretin. Hypocretin is a neurotransmitter in the brain that plays a role in wakefulness.
But levels of hypocretin may not tell the entire story. There may also be a genetic component. People with a family history of the condition have a higher risk of developing the disorder. Although more research is needed, narcolepsy may occur due a combination of genetics and an environmental trigger, such as an illness, trauma or intense stress.
Diagnosis of Narcolepsy
Several elements go into making a diagnosis of narcolepsy. For example, an extensive medical history and symptom review needs to be completed. A physical exam will also be performed to rule out other causes of symptoms. Patients may be asked to keep a sleep journal to help their doctor identify when
symptoms are occurring. Sleep studies including a polysomnogram and a multiple sleep latency test are also used to make a diagnosis.
Treatment of Narcolepsy
Although there is currently no cure for narcolepsy, there are a few narcolepsy treatments. For example, medications may be prescribed to decrease symptoms, such as excessive sleepiness and cataplexy. Medications approved by the FDA to treat the disorder include modafinil and sodium oxybate. Lifestyle changes and behavior strategies to improve sleep quality are also recommended, such as:
- Regular exercise
- Maintaining a comfortable sleep environment
- Keeping to a regular sleep schedule
- Relaxing before bed
- Maintaining a healthy weight
- Avoiding caffeine a few hours before bed
Mayo Clinic. Narcolepsy. http://www.mayoclinic.org/diseases-conditions/narcolepsy/basics/definition/con-20027429 Retrieved October 2016.
Mayo Clinic. Narcolepsy. Causes. http://www.mayoclinic.org/diseases-conditions/narcolepsy/basics/causes/con-20027429 Retrieved October 2016.
National Institute of Neurological Disorders and Strokes. Narcolepsy Fact Sheet. http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm#3201_2 Retrieved October 2016.
University of Maryland. Narcolepsy. http://umm.edu/health/medical/reports/articles/narcolepsy Retrieved October 2016.
MaryAnn DePietro, CRT is a medical writer and licensed respiratory therapist with over a decade of clinical experience, MaryAnn DePietro has been published in magazines, newspapers and on health websites. She earned degrees in both respiratory therapy and rehabilitation. As a therapist, she has worked with hundreds of patients with medical conditions, such as COPD, asthma, sleep apnea and cancer.
Summary: What is Narcolepsy? Symptoms, diagnosis and treatment options of narcolepsy with and without cataplexy.