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What Is Narcolepsy? Early Signs and Treatments to Consider

What Is Narcolepsy? Early Signs and Treatments to Consider
 

Characterised by sleep attacks, excessive sleepiness, sleep paralysis, hallucinations, and, for a few, cataplexy (the sudden loss of muscle control), narcolepsy is a rare neurological sleep disorder that affects roughly 1 in 2,000 to 3,000 people.i

While there’s no cure for narcolepsy, it can be greatly improved with certain lifestyle changes and management tools. Here, we explore the early signs of narcolepsy and available treatment options.


What are the symptoms of narcolepsy?

Narcolepsy can go undiagnosed for years as the condition can develop slowly; so understanding the symptoms can be enormously beneficial in reaching an early diagnosis.ii The sooner the diagnosis, the sooner you can implement the necessary measures to improve the quality of your sleep and wakefulness.

Although most individuals will only exhibit a few, these are the main symptoms of narcolepsy:iii


Excessive daytime sleepiness (EDS)

Experiencing pervasive fatigue and sleepiness and/or falling asleep at inappropriate times during the day.iv Excessive daytime sleepiness can also lead to reduced productivity, poor concentration, and compromised short-term memory. Insomnia and night-time disturbances are partly responsible for daytime sleepiness.


Cataplexy

Cataplexy attacks are typified by temporary involuntary muscle weakness in response to anticipated emotion or emotion.v  Positive emotions — most notably laughter — and negative emotions, such as embarrassment, fear, anger, and surprise are the most potent triggers.vi The severity and length of cataplexy attacks can vary; some people will experience mild jaw drooping, while others will fall to the ground completely. The episodes can last anywhere between a few seconds and two minutes. 


Sleep paralysis

Episodes usually occur during REM (rapid eye movement) sleep either when falling asleep or rousing from sleep.vii The experience is unusual in that individuals are conscious but simply cannot make themselves move. Frightening hallucinations often accompany this phenomenon.


Hypnagogic hallucinations

Scary, vivid dream-like experiences that happen during the shift between sleep and wakefulness.viii Often, these hallucinations accompany sleep paralysis. Most of the content is visual, however, other senses can be involved, too.


Insomnia

Although people with narcolepsy can feel extremely fatigued throughout the day, it’s not uncommon for narcoleptics to also experience insomnia and trouble sleeping through the night.ix Individuals with narcolepsy may wake up several times each night — due to vivid dreams or REM sleep behaviour disorder, for instance — exacerbating daytime sleepiness.

Narcolepsy can also trigger additional symptoms, such as memory problems, headaches, depression and automatic behaviour (continuing an activity without having any memory of it afterwards).x


What causes narcolepsy?

Experts believe narcolepsy has several causes. For individuals suffering from narcolepsy and cataplexy, it’s widely understood that a lack of the brain chemical hypocretin — which promotes wakefulness and regulates sleep — is responsible for triggering the condition.xi Indeed, hypocretin levels are usually healthy in people who have narcolepsy without cataplexy.

Though the aetiology of narcolepsy isn’t fully understood, existing research proposes that it may result from a combination of factors that work together to reduce hypocretin levels in the body.xii These factors include:xiii

  • Major psychological stress

  • Hormonal changes during puberty or the menopause

  • An infection, like streptococcal infection or swine flu

  • Autoimmune disorders

  • An inherited genetic fault

  • A sudden change in sleep patterns

 

What are the treatment options for narcolepsy?

While there’s no specific cure for narcolepsy, you can effectively manage the symptoms and reduce their effect on your daily life. Prioritising your sleep hygiene and making appropriate lifestyle changes can be particularly helpful.xiv


Establish good sleep hygiene

To minimise excessive daytime sleepiness and induce quality sleep at night, it’s critically important to focus on good sleep hygiene.

  • Give yourself a non-negotiable seven to nine-hour sleep opportunity window.

  • Try to go to bed and wake up at the same time every day

  • Keep your bedroom temperate, quiet, dark, and comfortable

  • Refrain from using technology in the 90 minutes before bed

  • Avoid stimulants, like caffeine and nicotine, before bed


Discover more ways to improve your sleep quality and wake up feeling energised here.


Take daytime naps

For many people with narcolepsy, a short nap – no longer than 15-20 minutes – can be refreshing, improving alertness and productivity. Be careful not to nap for too long however, as it can make it harder to fall asleep at night. Try scheduling in a brief nap when you feel sleepiest during the day.


Stay active

Sedentary activities can make you drowsy and sluggish — and this is especially true for those with narcolepsy. Make time for physical activity every day.  Even a brief walk can improve productivity and alertness.

Avoid heavy meals and sedating medication
Certain medications, including those used for depression, anxiety, allergies, and seizures, can exacerbate sleepiness. Heavy meals can have a similarly lethargic effect, so you may want to reduce your portion size.


Medication

If your symptoms are more severe, you should discuss the option of medication with your GP. Sometimes your doctor may prescribe a stimulant (dexamphetamine, modafinil, methylphenidate or pitolisant) or antidepressants.

Narcolepsy can impact many aspects of daily life — employment, education, relationships, emotional health, and even your ability to drive. But while there isn’t a cure for narcolepsy, the aforementioned strategies should help you manage symptoms and allow you to lead a full life.

To learn more about improving your sleep quality, explore the rest of our sleep health hub.
 



References:

  1. Sleepfoundation.org. What is Narcolepsy? - National Sleep Foundation. Available online: https://www.sleepfoundation.org/narcolepsy/what-narcolepsy

  2. Narcolepsy.org.uk. How is narcolepsy diagnosed? - Narcolepsy UK. Available online: https://www.narcolepsy.org.uk/resources/how-narcolepsy-diagnosed

  3. Narcolepsy.org.uk. What is narcolepsy? - Narcolepsy UK. Available online: https://www.narcolepsy.org.uk/resources/what-narcolepsy The Sleep Council. What is Narcolepsy? - The Sleep Council Available online: https://sleepcouncil.org.uk/sleep-hub/narcolepsy

  4. Sleepfoundation.org. Excessive Daytime Sleepiness - National Sleep Foundation. Available online: https://www.sleepfoundation.org/narcolepsy/symptoms/excessive-daytime-sleepiness

  5. Sleepfoundation.org. Cataplexy - National Sleep Foundation. Available online: https://www.sleepfoundation.org/narcolepsy/symptoms/cataplexy

  6. Narcolepsy.org.uk. Cataplexy - Narcolepsy UK. Available online: https://www.narcolepsy.org.uk/resources/cataplexy

  7. , , , , & Sensed presence as a correlate of sleep paralysis distress, social anxiety and waking state social imagery. Consciousness and Cognition. 17(1), 49-63.

  8. Healthysleep.med.harvard.edu. Symptoms - Narcolepsy. Available online: http://healthysleep.med.harvard.edu/narcolepsy/what-is-narcolepsy/narcolepsy_symptoms#Hallucinations

  9. Ninds.nih.gov. Narcolepsy Fact Sheet - National Institute of Neurological Disorders and Stroke. Available online: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet [Accessed 3 Sep. 2019].

  10. nhs.uk. Narcolepsy - Symptoms. Available online: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet [Accessed 3 Sep. 2019].

  11. Ninds.nih.gov. Narcolepsy Fact Sheet - National Institute of Neurological Disorders and Stroke. Available online: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet

  12. Ninds.nih.gov. Narcolepsy Fact Sheet - National Institute of Neurological Disorders and Stroke. Available online: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet

  13. nhs.uk. Narcolepsy - Causes. Available online: https://www.nhs.uk/conditions/narcolepsy/causes

  14. Healthysleep.med.harvard.edu. Self-Care - Narcolepsy. Available online: http://healthysleep.med.harvard.edu/narcolepsy/treating-narcolepsy/self-care

   

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Our Author - Olivia Salter

Olivia

Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.

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