Narcolepsy Diagnosis & Treatment

Are you having a hard time staying awake during the day? Narcolepsy is a sleep disorder that is characterized by excessive drowsiness during the daytime, as well as uncontrollable episodes of falling asleep. Narcolepsy can negatively affect almost every facet of your life and can be an incredibly dangerous sleep disorder.

Narcoleptic episodes can strike at any time, and when they hit you while operating a vehicle, eating, walking, or talking, it can be lethal. About one in 2,000 people have a form of narcolepsy; however, the majority of people with narcolepsy don’t realize they have it¹. If you think you might have narcolepsy, Emerald Sleep Disorders Center can help you get back to living a healthy and energetic life.

The Difference Between Narcolepsy & Normal Sleep Patterns

In normal sleep patterns, the process for falling asleep begins with a process called non-rapid eye movement (NREM) sleep. During NREM, your brain waves slow down. About an hour into the NREM phase, your brain activity changes, and REM sleep occurs, during which time most of your dreaming will take place.

In narcolepsy cases, you might enter REM sleep without experiencing NREM first. This can occur at night or during the day. Characteristics in REM sleep, like cataplexy, can occur during wake or sleep.

What Causes Narcolepsy?

The precise cause of narcolepsy is not known. However, there could be many causes. People with narcolepsy often have lower levels of a neurotransmitter called “hypocretin.” Hypocretin is one of the chemicals in your brain that helps control wakefulness and REM sleep. In some cases of narcolepsy, patients might also experience cataplexy.

Cataplexy is the cause of muscle paralysis during deep REM sleep cycles. When cataplexy occurs during the day, it leads to a loss of muscle tone, causing weakness in the arms, legs, and trunk, as well as slack jaw. However, the exact cause of the loss of hypocretin in the brain is unknown.

What are the Symptoms of Narcolepsy?

People suffering from narcolepsy might experience a range of symptoms. The most common symptoms of narcolepsy include:

  • Excessive daytime drowsiness. One of the first symptoms of narcolepsy is feeling tired during the day. When narcolepsy progresses, people with narcolepsy will randomly fall asleep anywhere at anytime. It’s not uncommon for people with narcolepsy to fall asleep in the middle of conversations or even half an hour after waking up. Narcolepsy also causes the sufferer to experience decreased alertness throughout the day. This is the most debilitating symptom associated with narcolepsy.
  • Loss of muscle tone. In narcolepsy with cataplexy, patients will experience a loss of muscle tone triggered by intense emotions, like laughter, excitement, fear, or anger. It’s not uncommon for patients with cataplexy to experience sudden buckling of the knees or uncontrollable head drooping when laughing. Some patients with narcolepsy experience cataplexy often, while others might not experience it at all.
  • Sleep paralysis. Patients with narcolepsy are more likely to experience sleep paralysis, a condition where they are temporarily unable to speak or move when they’re in a state of waking or falling asleep. Episodes of sleep paralysis typically only last for a few seconds or minutes. However, while they are occurring, they can be incredibly frightening. The brain activity that occurs during sleep paralysis typically happens during rapid eye movement (REM) levels of sleep, which is the level of sleep when dreaming occurs.
  • Hallucinations. Hallucinations called hypnagogic hallucinations are more common in patients with narcolepsy. They tend to occur when waking. Like sleep paralysis, hallucinations can be frightening and vivid.

It’s not uncommon for people with narcolepsy to have other sleep disorders, like obstructive sleep apnea, restless leg syndrome, or even insomnia. Narcoleptics are also more likely to act out their dreams while sleeping by flailing their arms, kicking, screaming, and more.

How Do We Diagnose Narcolepsy?

At Emerald Sleep Disorders Center, we will take a comprehensive assessment of your medical history and perform a physical exam to properly diagnose your narcolepsy. However, because many of the symptoms of narcolepsy are not exclusive to the sleep disorder, we will also need to perform a series of specialized tests in our sleep lab, before we can make an accurate diagnosis.

The most common test used to diagnose narcolepsy is the multiple sleep latency test (MSLT). The MSLT is done throughout the day to measure your ability to fall asleep and determine if elements of REM sleep occur during your waking hours. The MSLT consists of four to five short naps every two hours.

How is Narcolepsy Treated?

There is currently no cure for narcolepsy. However, we can treat the severe symptoms, so you’re able to live a fairly comfortable and normal life. Most of the severe symptoms of narcolepsy are treated with medications.

We are able to treat sleepiness with a stimulant similar to amphetamines, and the symptoms of abnormal REM sleep are treated with antidepressants. For patients with cataplexy, a new medication called “Xyrem” helps patients with narcolepsy and cataplexy get better sleep, feel less sleepy during the day, and control their loss of muscle control.

Certain lifestyle changes, like avoiding alcohol, nicotine, big meals, and caffeine can also help you minimize the symptoms of narcolepsy.

Choose Emerald Sleep Disorder Center for Narcolepsy

Is narcolepsy making you feel lethargic or interfering with your relationships or professional life? You don’t need to live with permanent drowsiness and the dangers of narcolepsy. The skilled sleep specialists at Emerald Sleep Disorder Center in Eugene, OR can help you establish healthy sleeping and wake patterns, so you can feel alert during your daily activities. Call us today to learn more about diagnosing and treating your narcolepsy at 541-683-3325.