Narcolepsy

Understanding Narcolepsy

Narcolepsy is a sleep disorder that causes excessive daytime sleepiness and sleep attacks—episodes of falling asleep in inappropriate places. People with narcolepsy experience irregularities in the normal sleep-wake cycle and fall into rapid eye movement (REM) sleep much more quickly. You may not realize you have narcolepsy because it often goes undiagnosed.

What are Causes of Narcolepsy?

Narcolepsy happens when your brain does not produce enough hypocretin, a chemical that controls wakefulness and appetite. This may be caused by genetic factors, injury or an autoimmune disorder where the body attacks certain chemicals in the brain.

What are Effects of Narcolepsy?

The effects of narcolepsy go beyond falling asleep during the day. Narcolepsy disrupts your daily activities and may cause you to feel depressed, constantly fatigued or like you cannot concentrate. It can even lead to weight gain when left untreated.

What are Symptoms of Narcolepsy?

Narcolepsy symptoms include:

• Frequent night waking
• Hallucinations before or after sleep
• Intensely vivid dreams
• Sleep attacks—falling asleep unexpectedly, in inappropriate places
• Sleep paralysis—a condition in which you cannot move for about a minute after waking up or falling asleep

A unique symptom of narcolepsy is cataplexy. During cataplexy, you experience a sudden loss in muscle tone and weakness while awake. Attacks may involve loss of control over one part of the body or be more severe causing you to collapse. These attacks are typically triggered by emotional situations. Not all patients with narcolepsy have cataplexy.

How is Narcolepsy Diagnosed?

Better sleep equals better overall well-being. IU Health sleep disorders specialists strive to improve your emotional, mental and physical health by helping you experience restful sleep. Diagnosis is always focused on convenience and comfort, with both daytime and evening sleep study testing.

The first step to diagnosing your condition includes a complete medical history to rule out other causes of your symptoms. For instance, excessive daytime sleepiness may be caused by insomnia or a medication you are taking.

Other diagnostic tools include:

Multiple Sleep Latency Test

During this daytime sleep study, physicians observe how long it takes you to fall asleep in a quiet room and if there are any irregularities in your sleep-wake cycle.

As with an overnight sleep study, electrodes are attached to your skin with an adhesive. The electrodes take measurements of your brain activity, monitoring how long it takes you to fall asleep and to enter rapid-eye-movement (REM) sleep.

Overnight Sleep Study

A nighttime sleep study monitors your brain activity and other bodily functions during sleep to assess if you are sleeping well. This test also helps check for other conditions that can cause daytime sleepiness such as sleep apnea or restless leg syndrome.

During an overnight sleep study, measurements are taken using cannulas, belts and electrodes attached to your skin with an adhesive. Eye movements and brain activity are observed, and your sleeping patterns are recorded on video. These measurements are used to map out your sleep pattern and note any abnormalities. An in-home sleep study may be an option, depending on your health and needs.

What are Treatment Options for Narcolepsy?

The goal of narcolepsy treatment is to help you live an active lifestyle with as few sleep attacks as possible. Your plan may include:

Education

Learning about certain lifestyle changes and good sleep hygiene help you take control of your narcolepsy. For example, having a set bedtime and a cool, dark place to sleep can lead to better quality sleep. Eating a good diet and exercising frequently also improves sleep quality.

Medicine Therapies

Stimulant medicines assist you in staying awake throughout the day. Certain stimulants can cause addiction, so you should take them exactly as your doctor prescribes.

They may also cause side effects such as headaches or heart palpitations. If you experience these symptoms, tell your physician. Other medicines, such as sodium oxybate, can help you sleep and get rid of symptoms of cataplexy. If you sleepwalk or have other sleep behaviors, this medicine may make it worse. These medicines may not help everyone. Your physician will work with you to find the best medicine for your specific condition.

Cognitive Behavioral Therapies

Speaking with a sleep psychologist reduces stress associated with sleep and may improve your ability to sleep. Having a sleeping issue can make you anxious about sleeping and you may hold false beliefs about how you have to sleep. Cognitive behavior therapies help you remodel your thinking, and teach you how to act around bedtime in order to fall asleep easier.

Nap Therapy

For some patients, scheduled short naps of about 20 minutes throughout the day decrease the number of sleep attacks. They can also reduce sleepiness and keep you more alert. This technique usually works best for children and can be difficult for adults to implement into their daily lives.