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All About Narcolepsy

Medically reviewed by Smita Patel, DO, Susan Kerrigan, MD and Marianne Madsen on January 19, 2023

Narcolepsy is a chronic disorder that causes an individual to fall asleep at sporadic moments throughout the day. The condition, while in and of itself generally harmless (it can lead to accidents!), can severely impact quality of life and lead to emotional distress. Around 200,000 Americans suffer from narcolepsy, and 3 million people worldwide live with the condition. Let’s find out what exactly narcolepsy is, what it’s caused by, and how it’s treated.


Signs and symptoms of narcolepsy


An individual with narcolepsy will experience excessive daytime sleepiness as their primary symptom. This can lead to something called a sleep attack, where the individual succumbs to their drowsiness and simply falls unconscious. Someone with narcolepsy can’t control when and where they fall asleep, and this often results in embarrassing or distressing situations for the individual.


Other symptoms of narcolepsy may include cataplexy, which is a temporary loss of muscle control triggered by strong emotions (laughter, anger). This often causes the narcolepsy sufferer to physically collapse. While cataplexy itself is not dangerous, it can put the individual in a potentially dangerous situation.


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Narcolepsy - Symptoms

Narcolepsy - Symptoms

Lastly, narcolepsy may cause sleep paralysis, where the individual cannot move or speak right after falling asleep or after waking up. Sleep paralysis may also lead to vivid hallucinations. This symptom is harmless, but can lead to further emotional distress as the person with narcolepsy can feel helpless because of their paralysis or frightened by their hallucinations.


Diagnosing narcolepsy


If you’ve been experiencing any of the above symptoms, see your doctor to rule out any other conditions, such as sleep apnea or restless leg syndrome. Your doctor may order a sleep study in some cases. 


Causes of narcolepsy


Experts aren’t sure what exactly causes narcolepsy. While many cases are caused by a deficiency in a brain chemical called hypocretin, which regulates wakefulness, other cases have no defined cause. It’s theorized that hormonal changes occurring during puberty or menopause, chronic stress, or certain infections such as the swine flu (H1N1 flu) could be responsible for triggering narcolepsy.


Genetics are thought to play a role, but a parent with narcolepsy has only a very small chance (about 1%) of passing the condition on to their child.


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Narcolepsy - Behavioral Treatments

Narcolepsy - Behavioral Treatments

Treating narcolepsy


There’s no cure for narcolepsy, but certain lifestyle changes and medications can treat the condition. Someone with narcolepsy should take frequent naps over the course of a day to minimize the chance of a sleep attack occurring. Many workplaces are willing to accommodate this sleep schedule. Going to bed at the same time each night can also help with daytime drowsiness.


Various medications can also be prescribed in more severe cases. Stimulants are the mainstay of pharmacological treatment; however, they can cause side effects such as headaches, nausea, or anxiety. They can also be addictive. Antidepressant drugs in the SSRI or SNRI classes are also used for cataplexy and sleep paralysis.


Living with narcolepsy


As narcolepsy can have a significant impact on one’s lifestyle and emotional state, coping can be difficult. Fortunately, support groups exist to help provide a sense of community around the disorder. A list of state-by-state support groups can be found on the Narcolepsy Network website.


Written by Natan Rosenfeld

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