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Narcolepsy is a sleep disorder that causes excessive sleepiness and frequent daytime sleep attacks.
Daytime sleep disorder; Cataplexy
Narcolepsy is a nervous system disorder. The exact cause is unknown.
In some patients, narcolepsy is linked to reduced amounts of a protein called hypocretin, which is made in the brain. What causes the brain to produce less of this protein is unclear.
There is a possibility that narcolepsy is an autoimmune disorder. An autoimmune disorder is when the body's immune system mistakenly attacks healthy tissue.
Narcolepsy tends to run in families. Certain genes are linked to narcolepsy.
Narcolepsy symptoms usually first occur during ages 15 to 30.
The most common symptoms are:
The doctor will perform a physical exam and order blood work to rule out conditions that can cause similar symptoms. Conditions that can cause excessive sleepiness include:
Other tests may include:
There is no known cure for narcolepsy. The goal of treatment is to control symptoms.
Lifestyle changes and emotional counseling may help you do better in work and social activities. This involves:
You may need to take prescription medications to help you stay awake. The stimulant drug armodafinil is usually tried first. It is much less likely to be abused than other stimulants. Other stimulants include dextroamphetamine (Dexedrine, DextroStat) and methylphenidate (Ritalin).
Antidepressant medications can help reduce episodes of cataplexy, sleep paralysis, and hallucinations. Antidepressants include:
Sodium oxybate (Xyrem) is prescribed to some patients for use at night.
If you have narcolepsy, you may have driving restrictions. Restrictions vary from state to state.
Narcolepsy is lifelong (chronic) condition.
It is not deadly, but it may be dangerous if episodes occur during driving, operating machinery, or similar activities.
Narcolepsy can usually be controlled with treatment. Treating other underlying sleep disorders can improve symptoms of narcolepsy.
Call your health care provider if:
There is no known way to prevent narcolepsy. Treatment may reduce the number of attacks. Avoid situations that aggravate the condition if you are prone to attacks of narcolepsy.
Biller J, Love BB, Schneck MJ. Sleep and its disorders. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 72.
Mahowald MW. Disorders of sleep. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 412.
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