what are the signs of narcolepsy?

the most common symptom of narcolepsy is excessive daytime sleepiness that makes it difficult to concentrate and dangerous to perform routine tasks such as cooking or driving, with patients sometimes falling asleep with no warning.

by dave yasvinski

published mar 12, 2023

last updated mar 13, 2023

4 minute read

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4 minute read

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there is no cure for narcolepsy, but lifestyle changes and medication can help manage symptoms. getty

narcolepsy is a neurological sleep disorder characterized by excessive daytime drowsiness that is the result of the brain’s inability to properly regulate the sleep-wake cycle. the condition stems from the loss of a neuropeptide in the brain known orexin (or hypocretin) that has an influence on sleep, arousal and energy expenditure. people suffering from narcolepsy often wake up feeling rested but are unable to sustain this level of alertness and soon experience chronic attacks of drowsiness throughout the day. these attacks, sometimes referred to as excessive daytime sleepiness (or eds), can be hard on patients and often result in emotional distress, according to the national sleep foundation.

if the condition is accompanied by the sudden loss of muscle tone (known as cataplexy) it is referred to as type 1 narcolepsy. if cataplexy is absent, it is known as type 2 narcolepsy. the condition, which usually appears at an early age, is experienced equally by men and women.

while there is no cure for narcolepsy, lifestyle changes and medication can help manage symptoms and improve quality of life for patients.

what are the symptoms of narcolepsy?

the most common (and obvious) symptom of narcolepsy is excessive daytime sleepiness that makes it difficult to concentrate and dangerous to perform routine tasks such as cooking or driving. patients will often suffer from sleep attacks so powerful that they will fall asleep in the middle of a task or conversation with no prior warning that their level of alertness has been compromised. these attacks, which generally last from a few seconds to a few minutes, are extremely distressing and can leave patients feeling frustrated and frightened.

other symptoms of narcolepsy include:

cataplexy. this brief, sudden loss of muscle tone can produce muscle weakness, slurred speech and even cause patients to collapse. in children, it may take the form of muscle tics, such as raised eyebrows or mouth movements. the symptom, which is usually triggered by intense emotions, is sometimes misdiagnosed as a seizure disorder

sleep paralysis and hallucinations. because narcolepsy disrupts the boundary between wakefulness and sleep, patients experience rem sleep (and other sleep cycles) more rapidly, which can result in dream-like hallucinations or muscle paralysis (a normal part of the sleep cycle)

difficulty sleeping at night. despite feeling tired throughout the day, roughly half of all narcolepsy patients have trouble falling and staying asleep at night

people with narcolepsy may also experience other sleep disorders, such as obstructive sleep apnea, insomnia and restless leg syndrome.

how is narcolepsy diagnosed?

when exploring a narcolepsy diagnosis, doctors will typically enquire about a patient’s sleep history, with the symptoms of eds and cataplexy usually enough to refer patients to a sleep specialist. there are two main tests that are used to confirm narcolepsy, according to the national organization for rare disorders:

an overnight polysomnogram (psg) – this test, conducted while a patient sleeps, provides a multitude of information on brain wave changes, eye movement, limb movement, heart rate, muscle tone and respiration

a multiple sleep latency test (mslt) – this test, conducted at two-hour intervals, measures how quickly patients are able fall asleep throughout the day

how is narcolepsy treated?

addressing this disorder typically involves a combination of lifestyle changes and medications to control symptoms and increase alertness, according to the cleveland clinic. these medications can include stimulants (to help keep patients awake during the day), antidepressants (to suppress rem sleep and manage cataplexy and hallucinations) and sodium oxybate (for eds and cataplexy). lifestyle changes can include:

adhering to a regular sleep schedule
keeping the bedroom dark and refraining from watching tv or other devices prior to sleep
avoiding alcohol and caffeine in the hours before bedtime
quitting smoking
exercising at least 20 minutes per day (but not in the hours before bedtime)
avoiding heavy meals or liquids before bedtime
relaxing before you go to sleep through things such as yoga, meditation or by taking a hot bath
taking short naps (no longer than half an hour) when feeling most tired

can i prevent narcolepsy?

because narcolepsy is caused by the loss of a neurotransmitter in the brain that helps regulate the sleep-wake cycle, there isn’t much that can be done to prevent a diagnosis.

how many people have narcolepsy?

it is estimated that one in 2,000 people — or around three million worldwide — live with narcolepsy, according to the narcolepsy network, although only about one in four people are believed to be actually receiving treatment for the condition. a recent study found that around 60 per cent of people with the condition are misdiagnosed.

support and resources for narcolepsy

sleep on it canada offers more information about narcolepsy and other sleep disorders, including sleep diaries, online courses and podcasts.

dave yasvinski is a toronto-based writer.

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dave yasvinski

what are the signs of narcolepsy?