Narcolepsy

A sleep disorder can significantly impact your quality of life. Since good sleep is just as essential as physical health, it’s important to address sleep disorders like narcolepsy, which can disrupt daily activities. The expert team at Banner Health can help you manage and treat narcolepsy, so you can live a more fulfilling life.

What is narcolepsy?

Narcolepsy is a chronic sleep disorder characterized by excessive daytime drowsiness and sudden sleep attacks. People with narcolepsy fall asleep unexpectedly and often have difficulty staying awake for extended periods. These episodes can be overwhelming, regardless of the situation.

There are two main types of narcolepsy:

• Narcolepsy type 1 (with cataplexy): This type includes sudden muscle weakness (cataplexy), which resembles the muscle paralysis experienced during REM sleep. Cataplexy can be triggered by strong emotions such as laughter, fear or stress. Symptoms vary, ranging from mild (like drooping eyelids) to severe (full-body collapse). Episodes can last from a few seconds to a few minutes.
• Narcolepsy type 2 (without cataplexy): People with narcolepsy type 2 experience excessive daytime sleepiness and other narcolepsy symptoms, but they do not have cataplexy.

Secondary narcolepsy is a rare form caused by brain injuries, particularly affecting the hypothalamus, which regulates sleep and waking.

What causes narcolepsy?

The exact cause of narcolepsy remains unclear, but researchers have linked narcolepsy type 1 to low levels of hypocretin, a brain chemical that regulates wakefulness and REM sleep. This deficiency may be due to an autoimmune response. Genetic factors and certain infections, like the H1N1 flu virus, may also increase the risk.

Symptoms of narcolepsy

Narcolepsy symptoms can appear gradually and often worsen over time. Key symptoms include:

• Excessive daytime sleepiness: Persistent drowsiness that impacts daily life.
• Cataplexy: Sudden loss of muscle tone, often triggered by emotions.
• Sleep paralysis: Inability to move or speak while falling asleep or waking.
• REM sleep changes: Experiencing REM sleep too soon or for longer periods.
• Hallucinations: Vivid dreams or images as you’re falling asleep or waking.

People with narcolepsy may also experience other sleep disorders like sleep apnea, insomnia or restless leg syndrome.

How is narcolepsy diagnosed?

To diagnose narcolepsy, your doctor will start with a review of your symptoms, focusing on daytime sleepiness and any episodes of cataplexy. You may be referred to a sleep specialist for detailed testing.

Diagnostic tests Include:

• Polysomnography (sleep study): An overnight study to monitor your sleep patterns.
• Multiple sleep latency test (MSLT): A nap study conducted the next day to measure how quickly you fall asleep and enter REM sleep.
• Epworth sleepiness scale: A questionnaire to assess your level of daytime drowsiness.

These tests help rule out other sleep disorders like sleep apnea or the side effects of certain medications.

Treating narcolepsy

While there is no cure for narcolepsy, treatment options can significantly reduce symptoms. These include:

• Medications:
  • Stimulants: Help keep you awake during the day.
  • SSRIs or SNRIs: Alleviate cataplexy, sleep paralysis, and hallucinations.
  • Tricyclic antidepressants: Manage cataplexy symptoms.
  • Sodium oxybate: Improves nighttime sleep and reduces daytime sleepiness.

Your doctor will work with you to tailor a treatment plan that suits your needs.

Lifestyle tips for managing narcolepsy

In addition to medication, lifestyle adjustments can help manage symptoms:

• Take short naps: Schedule 20-minute naps during the day to boost alertness.
• Follow a sleep routine: Stick to a consistent sleeping and waking schedule, even on weekends.
• Exercise regularly: Aim for moderate activity 4 to 5 hours before bedtime.
• Avoid stimulants: Steer clear of nicotine and alcohol, which can disrupt sleep.

If you plan to drive long distances, talk to your doctor about staying awake safely. Take breaks to nap or move around as needed.

If you think you might have narcolepsy, our Banner Health sleep specialists can help create a personalized treatment plan. Schedule a consultation today.