Narcolepsy is a chronic, neurological sleep disorder with no known cause. It involves the body's central nervous system. Narcolepsy is a genetic disorder, but what causes narcolepsy is not yet known.

The main characteristic of narcolepsy is excessive and overwhelming daytime sleepiness, even after adequate nighttime sleep.

A person with narcolepsy is likely to become drowsy or fall asleep at inappropriate times and places, and sleep attacks may occur with or without warning.

Attacks can occur repeatedly in a single day, drowsiness may persist for prolonged periods of time, and nighttime sleep may be fragmented with frequent awakenings.

Narcolepsy symptoms

The following are the most common symptoms of narcolepsy. However, individuals may experience symptoms differently.

Symptoms may include:

• Excessive daytime sleepiness — an overwhelming desire to sleep at inappropriate times.
• Cataplexy — a sudden loss of muscle control ranging from slight weakness to total collapse.
• Sleep paralysis — being unable to talk or move for about one minute when falling asleep or waking up.
• Hypnagogic hallucinations — vivid and often scary dreams and sounds reported when falling asleep.

Some patients also report:

• Automatic behavior — performing routine tasks without conscious awareness of doing so, and often without memory of it.
• Disrupted nighttime sleep — waking up multiple times in the night.

For people struggling to cope with the effects of narcolepsy, symptoms may expand to include:

• Feelings of intense fatigue and continual lack of energy
• Depression
• Difficulty in concentrating or memorizing
• Vision (focusing) problems
• Eating binges
• Weak limbs
• Difficulties in handling alcohol

Narcolepsy diagnosis

In addition to a complete medical history and physical exam, diagnostic procedures may include lab tests such as:

• Overnight polysomnogram (sleep study).
• Multiple sleep latency testing, which measures how long it takes you to fall asleep and how long each sleep cycle is.
• Genetic blood tests to check for markers related to narcolepsy. 

Narcolepsy treatment

Specific treatment will be determined by your physician based on:

• Your age, overall health and medical history
• Extent of the disease
• Your tolerance for specific medications, procedures or therapies
• Expectations for the course of the disease
• Your opinion or preference

The treatment goal is to help you remain as alert as possible during the day and to minimize any recurring episodes of cataplexy, while using a minimal amount of medication. Your sleep doctor may recommend:

• Medications — excessive daytime sleepiness and cataplexy are treated separately, with central nervous system stimulants usually prescribed for EDS and tricyclic antidepressants for cataplexy.
• Nap therapy - two or three short naps during the day to help control sleepiness and maintain alertness
• Modified diet
• Exercise 

The first step is getting checked

If you’re having problems sleeping more than three times a week for a month, see your health care provider and ask for a referral to Salem Health’s Sleep Center to be evaluated for a sleep disorder.

You will be seen by a sleep medicine specialist who will identify possible sleep disorders such as obstructive sleep apnea or restless leg syndrome.

Depending on your needs, sleep testing can be performed in your home or in the state-of-the-art sleep laboratory at Salem Hospital by experienced, licensed sleep technologists.

Identifying and treating the cause of your sleep disturbance can help get you back on the road to a good night’s sleep and improved health.