Last reviewed:
21st Dec 2022
PhD, OTR/L
Narcolepsy is a sleep disorder in which people experience uncontrollable sleep attacks. It is treated primarily with medication as well as behavioral modifications, which can be implemented to create an optimal sleep schedule [1].
Narcolepsy is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), as a sleep-wake disorder. Per diagnostic criteria, narcolepsy involves repeated periods during which a person has an irresistible urge to sleep, lapses into sleep, or naps over the course of the same day [2].
In addition to these sleep episodes, a person with narcolepsy experiences other symptoms, including episodes of cataplexy, during which they lose muscle tone but maintain consciousness. For children, cataplexy involves sudden grimacing or an episode of jaw opening in which the tongue is thrust forward [2].
There are two overarching types of narcolepsy: type 1 and type 2, which are described below [3]:
Common symptoms of narcolepsy are as follows [4]:
There is not one single cause of narcolepsy, but rather several risk factors that can increase the likelihood that a person will develop the condition:
A doctor making a diagnosis of narcolepsy will obtain a medical history from the patient. Narcolepsy is suspected when a patient experiences severe daytime sleepiness. Before diagnosis is made, a doctor will inquire if a patient is consistently getting 6 hours of sleep or more per night. Narcolepsy cannot be diagnosed if a patient consistently sleeps fewer than 6 hours each night [1].
If narcolepsy is suspected, a polysomnogram, or sleep study is conducted to rule out other sleep disorders and to ensure a patient is sleeping at least 6 hours per night. Next, a doctor will complete a Multiple Sleep Latency Test (MSLT), during which a patient is given the opportunity to nap for 20 minutes. If a patient has narcolepsy, they will take a short amount of time to fall asleep, fewer than 8 minutes on average, and they will rapidly enter REM sleep [1].
Finally, a doctor will test hypocretin levels to confirm the narcolepsy diagnosis [1].
There is no known way to prevent narcolepsy. Instead, a person can learn to manage the condition through quality treatments and self-care.
With treatment, narcolepsy can be manageable. The following treatments are effective for individuals with narcolepsy [1]
Medications used to treat cataplexy include sodium oxybate, protriptyline, clomipramine, fluoxetine, and venlafaxine as an off-label alternative.
If you live with narcolepsy, there are ways that you can care for yourself to improve your quality of life. Some helpful self-care strategies for narcolepsy include [4]:
If you’re looking for information on narcolepsy, the answers to the following questions can also be helpful.
The prevalence of narcolepsy depends on the type. For narcolepsy type 1, prevalence is 14 per 100,000 people. For type 2, prevalence is 65.4 per 100,000 people. The condition is more common in women compared to men and develops most commonly during the teenage years and the early twenties [1].
Behavioral treatments and medications can make it easier to manage narcolepsy. However, it is a lifelong condition, and there is evidence that it tends to worsen over time. People who have narcolepsy may have a difficult time maintaining employment, and children with narcolepsy often struggle at school [1].
Narcolepsy can also cause injuries and accidents, and it may be dangerous to drive or operate heavy machinery if you have this condition [4].
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