Narcolepsy Overview

Narcolepsy is a chronic sleep disorder that's characterized by an overwhelming feeling of daytime drowsiness and a sudden need to sleep, which can lead to serious daily challenges. People with narcolepsy often find it difficult to stay awake for long periods of time, according to the Mayo Clinic.

What Is It?

If you can't stay awake, even after a full night's sleep, you may have narcolepsy, a neurological sleep disorder that prompts you to nod off whenever you're sedentary, including at work and behind the wheel.

Types

Narcolepsy may be paired with a sudden, uncontrollable loss of muscle tone, known as cataplexy, which can be prompted by an intense emotional response, either positive or negative, according to the Mayo Clinic. Narcolepsy that occurs with cataplexy is known as type 1 narcolepsy. Narcolepsy that occurs without cataplexy is known as type 2 narcolepsy.

Symptoms

The first sign that you have narcolepsy is that you feel an overwhelming feeling of drowsiness during the day. Here are the other signs and symptoms of narcolepsy which tends to be worse when it first occurs and then continues for life, according to the Mayo Clinic:

• Excessive daytime sleepiness. People with narcolepsy fall asleep without warning. You may be working or talking and suddenly you nod off, sleeping for a few minutes up to a half-hour. When you awaken, you feel refreshed, but eventually you get sleepy again. This can be paired with decreased alertness and focus throughout the day.
• Loss of muscle tone. This condition, called cataplexy occurs suddenly and can cause slurred speech and a complete weakness of most muscles. These symptoms may last up to a few minutes.
• Sleep paralysis. You may experience a temporary inability to move or speak while falling asleep or upon waking. These brief episodes last seconds or minutes but can be quite upsetting since you may not recall them afterwards.
• Changes in REM sleep. When you have narcolepsy, you often move quickly into deeper, rapid eye movement (REM) sleep, within 15 minutes of falling asleep.
• Hallucinations. One of the hallmarks of narcolepsy are vivid and often scary hallucinations that can either occur as you're falling asleep or right before you wake up.

Causes

Currently, there are only a few known risk factors for narcolepsy, including:

• Age. Narcolepsy typically begins in people between 10 and 30 years old.
• Family history. In 10 percent of cases your narcolepsy is derived from a family history of the disorder

In fact, the exact cause of narcolepsy is unknown, according to the Mayo Clinic. Some narcolepsy patients have low levels of hypocretin, a neurochemical in your brain that helps regulate wakefulness and REM sleep.

Research also indicates that there may be an association with narcolepsy and exposure to the swine flu (H1N1 flu) virus and a certain form of H1N1 vaccine that's currently administered in Europe, according to the Centers for Disease Control (CDC), though researchers are still studying this possible connection.

Diagnosis

To diagnose your narcolepsy, symptoms matter. Excessive daytime sleepiness is a first clue to your healthcare provider that you have narcolepsy. If this is the case, you may be sent to a sleep specialist and may even stay overnight at a sleep center so you can be evaluated overnight, according to the Mayo Clinic.

During that overnight evaluation, you will likely be given a polysomnogram (PSG) and, the next day, you may be asked to take a multiple sleep latency test (MSLT), during which you will take several short naps during the day to see how quickly you fall asleep. All of these evaluations can help confirm that you have narcolepsy.

Treatment

While there is no cure for narcolepsy, experts recommend behavioral therapy such as budgeting time for naps, focusing on having good sleep hygiene and avoiding alcohol and heavy meals, according to the Mayo Clinic.

There are also several prescription medications that may be recommended if you have narcolepsy, including antidepressants and Modafinil, sold as Provigil, that has been shown to boost the amount of dopamine—otherwise known as the 'feel-good' chemical that drives the brain's reward system. According to a study in the Journal of the American Medical Association, this particular drug upped dopamine levels in a part of the brain involved in feeling pleasure.

Prevention

While there is no way to prevent narcolepsy, experts recommend reducing your risk factors. To that end, incorporate exercise into your daily routine to prompt sleepiness at night and prevent weight gain, avoid extreme emotional swings and try to create a support system of friends and family you can lean on.

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