Overview

Narcolepsy is a chronic sleep disorder marked by overwhelming daytime and sudden sleep attacks. Individuals with narcolepsy often find it hard to stay awake for long periods, whatever the circumstances might be. Narcolepsy can cause severe disruption to your everyday routine.

Narcolepsy can be followed by a sudden loss of muscle tone (cataplexy), which may be caused by intense emotion. Narcolepsy that occurs with cataplexy is known as type 1 narcolepsy. Narcolepsy occurring without cataplexy is known as Narcolepsy type 2.

Narcolepsy is an old condition that isn’t treated for. Nonetheless, improvements in medicine and lifestyle will help you control the symptoms. Support from family, friends, colleagues, teachers and others will help you deal with narcolepsy.

Symptoms

For the first few years, the signs and symptoms of narcolepsy can worsen and then continue for life. They include:

Excessive daytime sleepiness: People with narcolepsy fall asleep without warning, anywhere, anytime. For example, you may be working or talking with friends and suddenly you nod off, sleeping for a few minutes up to a half-hour. When you awaken, you feel refreshed, but eventually, you get sleepy again.

You may also experience decreased alertness and focus throughout the day. Excessive daytime sleepiness usually is the first symptom to appear and is often the most troublesome, making it difficult for you to concentrate and fully function.

Sudden loss of muscle tone: This condition, called cataplexy (KAT-uh-plek-see), can cause several physical changes, from slurred speech to complete weakness of most muscles, and may last up to a few minutes.

Cataplexy is uncontrollable and is triggered by intense emotions, usually positive ones such as laughter or excitement, but sometimes fear, surprise or anger. For example, when you laugh, your head may droop uncontrollably or your knees may suddenly buckle.

Some people with narcolepsy experience only one or two episodes of cataplexy a year, while others have numerous episodes daily. Not everyone with narcolepsy experiences cataplexy.

Sleep paralysis: Individuals with narcolepsy often experience a temporary inability to move or talk while sleeping or waking. Such episodes are usually brief lasting a couple of seconds or minutes but can be frightening. You may be aware of the condition and have no difficulty recalling it afterwards, even if you had no control over what was happening to you.

This sleep paralysis mimics the form of temporary paralysis usually occurring during a sleep cycle called rapid eye motion (REM) sleep. During REM sleep this temporary immobility can prevent your body from carrying out dream activity.

However, not everyone with sleep paralysis does have narcolepsy. Many people without narcolepsy experience some episodes of sleep paralysis.

Changes in rapid eye movement (REM) sleep: Usually, REM sleep is when much of the dreaming occurs. REM sleep in people with narcolepsy can occur at any time of day. Individuals with narcolepsy often rapidly transition to REM sleep, usually within 15 minutes of falling asleep.

Hallucinations: Such hallucinations are considered hypnagogic hallucinations if they happen when you fall asleep and hypnopompic hallucinations if they occur at waking. An example of this is feeling like a stranger is in your bedroom. Such hallucinations can be especially vivid and terrifying because when you begin to dream, you might not be fully asleep and experience your dreams as truth.

When to see a doctor

If you experience prolonged daytime sleepiness that is affecting your personal or professional life, see your doctor.

Causes

It is unclear what exactly causes narcolepsy. People with type 1 narcolepsy have a low level of chemical hypocretin (hi-Poe-KREE-tin). Hypocretin is a necessary neurochemical in your brain which helps control wakefulness and REM sleep.

Hypocretin levels in those suffering from cataplexy are especially low. It’s not clear precisely what causes the loss of hypocretin-producing cells in the brain, but experts believe it’s because of an autoimmune reaction.

It’s also possible genetics may play a role in narcolepsy development. But a parent’s chance of transmitting the condition to a child is very low—only around 1 per cent.

Research also indicates a possible association with exposure to the swine flu (H1N1 flu) virus and a certain form of H1N1 vaccine currently being administered in Europe, although it is not yet clear why.

Normal sleep pattern v/s narcolepsy

The normal falling asleep cycle starts with a sleep period called non-rapid eye motion (NREM). Your brain waves slow considerably during this process. The brain function changes after an hour or so of NREM sleep, and the REM sleep begins. Most dreaming takes place during REM sleep.

In narcolepsy, however, you may suddenly enter into REM sleep without first experiencing NREM sleep, at night and during the day both. Some of the narcolepsy symptoms such as cataplexy, sleep deprivation, and hallucinations are similar to changes occurring in REM sleep, but occurring during wakefulness or drowsiness.

Risk factors

There are some known narcolepsy risk factors, including:

Age: Narcolepsy usually begins at people between the ages of 10 and 30.

History of family: When you have a family member that has narcolepsy, the chance of narcolepsy is 25-45 times higher.

Public misunderstanding of the condition: Narcolepsy may cause for you professional and personal grave problems. Others might find you lazy or lethargic. At school or work, success may be suffering.

Interference with intimate relationships: Intense emotions such as frustration or excitement can cause symptoms of narcolepsy such as cataplexy, leading to affected individuals to isolate from emotional interactions.

Physical harm: Sleep attacks can cause physical damage to narcolepsy sufferers. When you have an assault while driving you’re at greater risk of a car crash. If you fall asleep while cooking food, the chance of cuts and burns is greater.

Weight gain: People with narcolepsy are more likely to be overweight. Obesity may be related to low metabolism.