Narcolepsy is a lifelong neurologic sleep disorder associated with overwhelming sleepiness (hypersomnia) and, in severe cases, sudden uncontrollable sleep attacks. Symptoms usually begin between the ages of 15-30, but may start at a much younger or older age. About 1 in 2,000 people have some form of narcolepsy – many do not realize that they have a sleep disorder. While the precise cause of narcolepsy is unknown, research suggests that many patients have low levels of the neurotransmitter hypocretin, an important chemical made in a part of the brain called the hypothalamus that regulates arousal and wakefulness. In addition to hypersomnia, symptoms of narcolepsy may include vivid hallucinations near sleep onset, frequent nocturnal awakenings, temporary paralysis when you are falling asleep or waking up, and cataplexy. Cataplexy refers to a sudden loss of muscle tone while you are awake triggered by strong emotions like surprise, laughter, excitement, or anger. It may lead to slurred speech, buckling knees, sagging of the face muscles, or even complete paralysis. Cataplexy is a very specific feature of narcolepsy.
Consultation with a sleep specialist is the first step in establishing the diagnosis. Other sleep disorders (i.e. sleep apnea, RLS, and circadian rhythm sleep disorders) as well as certain medical conditions, medications, and mental health disorders are often mistaken for narcolepsy. Testing with an overnight sleep study followed by a daytime nap study is required in most cases for complete evaluation. Although narcolepsy has no cure, it is manageable through medications and lifestyle changes. Your sleep specialist is likely to prescribe stimulant medication to help you stay awake during the day, but other important treatment considerations are often indicated.