Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine.
Contrary to what some people believe, narcolepsy isn't related to depression, seizure disorders, fainting, simple lack of sleep or other conditions that may cause abnormal sleep patterns.
Narcolepsy is a chronic condition for which there's no cure. However, medications and lifestyle changes can help you manage the symptoms. Talking to others — family, friends, employer, teachers — can help you cope with narcolepsy.
Symptoms of narcolepsy may worsen for the first few years, and then continue for life. They include:
Some episodes of sleep attacks are brief, lasting seconds. Some people with narcolepsy experience automatic behavior during these brief episodes. For example, you may fall asleep while performing a task you normally perform, such as writing, typing or driving, and you continue to function while asleep. When you awaken, you can't remember what you did, and you probably didn't do it well. For instance, if you were writing, what you wrote asleep may look like scribbling.
The signs and symptoms of narcolepsy can begin anytime up to your 50s, but they most commonly begin between the ages of 10 and 25. Symptoms often are more severe for those who develop them early in life, rather than in adulthood.
When to see a doctor
The exact cause of narcolepsy isn't known. Genetics may play a role. Other factors, such as infection, stress or exposure to toxins, may contribute to the development of narcolepsy.
Normal sleep pattern vs. narcolepsy
In narcolepsy, however, you may suddenly enter into REM sleep without first experiencing NREM sleep, both at night and during the day. Some of the characteristics of REM sleep, such as sudden lack of muscle tone, sleep paralysis and vivid dreams, occur during other sleep stages in people with narcolepsy.
The role of brain chemicals
Public misunderstanding of the condition
Interference with intimate relationships
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a sleep specialist.
Here's some information to help you prepare for your appointment.
What you can do
Preparing a list of questions for your doctor will help you make the most of your time together. List your questions from most important to least important. For narcolepsy, some basic questions to ask your doctor include:
Don't hesitate to ask other questions anytime during your appointment.
What to expect from your doctor
Tests and diagnosis
Your doctor may make a preliminary diagnosis of narcolepsy based on your excessive daytime sleepiness and sudden loss of muscle tone (cataplexy). After an initial diagnosis, your doctor may refer you to a sleep specialist for more evaluation.
Formal diagnosis may require staying overnight at a sleep center, where you undergo an in-depth analysis of your sleep by a team of specialists. Methods of diagnosing narcolepsy and determining its severity include:
These tests can also help doctors rule out other possible causes of your signs and symptoms. Other sleep disorders, such as sleep apnea, can cause excessive daytime sleepiness.
Another test your doctor might recommend is a hypocretin test, which measures the levels of hypocretin in the fluid that surrounds your spinal cord. Most people with narcolepsy have low levels of this brain chemical that regulates REM sleep. A sample of your spinal fluid is obtained with a lumbar puncture (spinal tap), during which a needle is inserted into your lower spine to withdraw spinal fluid.
Treatments and drugs
There is no cure for narcolepsy, but medications and lifestyle modifications can help you manage the symptoms.
If you have other health problems, such as high blood pressure or diabetes, ask your doctor how the medications you take for your other conditions may interact with those taken for narcolepsy.
Certain over-the-counter drugs, such as allergy and cold medications, can cause drowsiness. If you have narcolepsy, your doctor will likely recommend that you avoid taking these medications.
Lifestyle and home remedies
Lifestyle modifications are important in managing the symptoms of narcolepsy. You may benefit from these steps:
Coping and support
Dealing with narcolepsy can be challenging. Making adjustments in your daily schedule may help. Consider these tips:
Support groups and counseling can help you and your loved ones cope with narcolepsy. Ask your doctor to help you locate a group or qualified counselor in your area.
Last Updated: 2010-05-15
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