Narcolepsy is a sleep disorder defined by constant sleepiness and a tendency to sleep at inappropriate times. Typically, a person with narcolepsy suffers sleep attacks as well as continual sleepiness and a feeling of tiredness that is not completely relieved by any amount of sleep. If not recognized and appropriately managed, narcolepsy can drastically and negatively affect the quality of a person’s life.

The exact cause of narcolepsy is not known, though it appears to be a disorder of the part of the brain that controls sleep and wakefulness. Sometimes it runs in families. Although a cure for narcolepsy has not yet been found, most people with this disorder can lead nearly normal lives under proper treatment.

SYMPTOMS

The symptoms of narcolepsy can appear all at once or can develop gradually over many years.

• Excessive daytime sleepiness. This is usually the first symptom noticed. People feel continually tired or sleep all of the time. They fall asleep while watching a movie, during a conversation or in dangerous situations such as driving.
• Cataplexy. These sudden, brief losses of muscle control may be a feeling of being weak in the knees…or may cause a complete physical collapse. It occurs when the person is fully awake. Cataplexy is usually triggered by strong emotion, such as laughing, anger or surprise.
• Sleep Paralysis. This is also a brief loss of muscle control, but it occurs when the person is falling asleep or waking up. Sleep paralysis can be frightening, but is not dangerous.
• Hynagogic Hallucinations. These vivid dream-like experiences can occur when a person is drowsy. They may involve disturbing images or sounds, such as of strange animals or prowlers.

TREATMENT OPTIONS

If you experience any of the symptoms of narcolepsy and find those symptoms affecting your ability to drive, hold a job, stay in school or perform daily activities, you should see your health care professional. The first step would be to make sure that a mental illness is not the cause. The next step would be referral to a sleep specialist.

At the Evergreen Sleep Disorders Center, our sleep specialist would thoroughly review your medical history and perform a complete physical exam. If narcolepsy is suspected, you might be asked to undergo a sleep study at the Center, where you would undergo a polysomnogram and a multiple sleep latency test. Results of the tests – together with your symptoms – will help our sleep specialist determine whether your symptoms are caused by narcolepsy of another disorder that shares its symptoms.

Although narcolepsy cannot yet be cured, its symptoms can usually be controlled or improved so that sufferers experience symptoms less frequently and lead fairly normal lives. A treatment plan for narcolepsy would likely have several parts, including medications, lifestyle adjustments and management of your environment.

• Medication. Prescription medications are available and can be effective in controlling excessive daytime sleepiness, cataplexy, hallucinations and sleep disruptions.
• Lifestyle Adjustments. Follow a regular sleep/wake schedule. Take regular short naps. Schedule potentially dangerous activities (driving, cooking) at times you are most alert. Follow your health care provider’s instructions regarding medications.
• Management of the Environment. Educate your family members and friends, and call on them for support. Educate your employer and ask for certain accommodations at work that can help you be a productive employee. Find a narcolepsy support group.