Narcolepsy is caused by a neurological condition that disrupts your ability to control the natural sleep-wake cycle. This often results in uncontrollable periods of sleep and wakefulness, causing excessive daytime sleepiness (EDS).
This chronic neurological condition can cause sudden bouts of sleep during the day, which can negatively impact daily routines and activities. However, through a combination of lifestyle approaches and medications, there are a number of ways to reduce and minimize the impact of narcolepsy on your life.
Narcolepsy symptoms almost always include excessive daytime sleepiness (EDS). This type of sleepiness can come in the form of an inability to concentrate, a feeling of brain fog, memory problems, exhaustion, or depression.1
Signs of narcolepsy can be the presence of cataplexy (sudden loss of muscle tone), hallucinations, and sleep paralysis. Those with narcolepsy may also experience a different type of sleeping and dreaming cycle than those without narcolepsy. During a typical deep sleep, people without narcolepsy will fall into rapid-eye-movement (REM) sleep after approximately 60–90 minutes. Conversely, those who suffer from narcolepsy often reach this deep sleep state within fifteen minutes.2 During this time, narcoleptics often experience vivid dreams, nightmares, or sleep paralysis.
Because people with narcolepsy often have unexpected “sleep attacks,” they may also have trouble sleeping at the appropriate times, such as bedtime. Narcolepsy can also cause intense dreaming that often feels vivid and life-like.
Narcolepsy can be categorized into two main types. They are differentiated as narcolepsy with cataplexy (Type 1) and narcolepsy without cataplexy (Type 2).3
Narcolepsy Type 1 is very rare and involves the presence of cataplexy. Cataplexy is the sudden and uncontrollable loss of muscle control when awake. These periods of cataplexy can range in their intensity, and are typically triggered by feeling intense emotions. They can last anywhere between a couple seconds to several minutes. It can manifest as drooping eyes, buckling knees, or a full collapse with the inability to speak or move. Unlike in seizure disorders, people with cataplexy are fully conscious during these episodes.4 Narcolepsy with cataplexy is also associated with low levels of the brain chemical hypocretin. Hypocretin is a brain chemical that promotes alertness and helps regulate REM sleep.5
Narcolepsy Type 2 is more common, and is narcolepsy that occurs without cataplexy. This type similar to Type 1 comes with excessive tiredness, but is usually less severe in its effects.
The exact causes of narcolepsy are still not entirely understood. There are several factors that are known to contribute to the onset of this condition, such as having low levels of hypocretin.6 Other factors that are known to contribute to the onset of both types of narcolepsy are genetics or a family history of narcolepsy, autoimmune disorders that affect hypocretin levels, brain trauma or injury, and certain infections.
Yes, narcolepsy can develop suddenly or gradually over time.7 It usually develops between the ages of 7–25, but you can develop narcolepsy at any age.
Narcolepsy is a chronic lifelong condition. However, there are ways to manage it, and the symptoms can improve over time.
Narcolepsy causes are not fully understood. Currently, there are several factors that are known to contribute to the presence or onset of narcolepsy. Narcolepsy with cataplexy is very often caused by having low levels of hypocretin, neuropeptides which moderate sleepiness in the brain.8 Additionally, brain trauma, a family history of narcolepsy, or an illness can also bring on narcolepsy.
A narcoleptic “sleep attack” often feels the inability to stop oneself from falling asleep despite what you are doing. This can happen in the middle of a conversation or even while driving.
There are several options for narcolepsy treatment and management. Depending on the type of narcolepsy, different medications may be recommended. Some medications include antidepressants, stimulants, or sodium oxybate. Other methods involve trying to find ways to improve sleep through tactics like scheduling naps and avoiding stimulants later during the day. Narcolepsy treatment differs from person to person, depending on individual needs. Sleep studies and a sleep specialist can help find the most appropriate set of treatment.
© 2021 American Sleep Association.