EXCESSIVE SLEEPINESS (NARCOLEPSY)

Narcolepsy is a chronic neurological disorder caused by the brain's inability to regulate sleep-wake cycles normally. At various times throughout the day, people with narcolepsy experience fleeting urges to sleep. If the urge becomes overwhelming, individuals will fall asleep for periods lasting from a few seconds to several minutes. In some cases, people may remain asleep for an hour or longer.

CAUSES

The cause of narcolepsy is not known.  Narcolepsy is a genetic disorder.  It is caused by a deficiency in the production of a neurotransmitter that helps neurons talk to each other.

 

 

SYMPTOMS

People may experience symptoms differently. Symptoms may include:

  • Excessive daytime sleepiness (EDS)

  • Cataplexy

  • Sleep paralysis

  • Hallucinations

Other symptoms include:

  • Automatic behavior (sleep walking)

  • Disrupted sleep/wake cycle

 

 

COMPLICATIONS

  • Fatigue

  • Depression

  • Mental fog

  • Vision disturbances

  • Poor diet

  • Weak limbs

  • Alcohol increases symptom intensity

 

DIAGNOSIS

Diagnosis begins with a proper history and physical exam.  Other helpful tests may include:

  • Polysomnography (PSG):  A sleep specialist will monitor you during an entire night of sleep while you are hooked up to a series of leads that measure biofeedback in addition to brainwaves.

  • Multiple sleep latency test (MSLT):  This test measures when you fall asleep and how quickly rapid eye movement (REM) sleep occurs.

  • Genetic blood test: To test for a genetic mutation often found in people who tend to have narcolepsy.

 

TREATMENT

Treatment will be determined by your healthcare provider based on:

  • Your age, overall health, and medical history

  • Severity of the disease

  • Your tolerance for specific therapies

The goal of treatment is to help you be as alert as you can during the day and to minimize muscle side effects.  Treatments may include:

  • Medicines:  Stimulants are usually prescribed for excessive sleepiness and antidepressants for help with muscle control.

  • Nap therapy:  A few short naps during the day may alleviate symptoms.

  • Proper diet

  • Regular exercise

  • Behavioral therapy

There is no cure for narcolepsy.  Two classes of antidepressant drugs, tricyclic antidepressants and selective serotonin reuptake inhibitors, have proved effective in controlling cataplexy in many patients. Many people with narcolepsy take short, regularly scheduled naps at times when they tend to feel sleepiest. Improving the quality of nighttime sleep can combat excessive daytime sleepiness and help relieve persistent feelings of fatigue.  No treatment will alleviate all of the underlying symptoms, but excessive daytime sleepiness and cataplexy, the most disabling symptoms of the disorder, can be controlled in most patients with drug treatment. Often the treatment regimen is modified as symptoms change.

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