Narcolepsy

Narcolepsy facts

Narcolepsy is a serious sleep disorder that affects about 1 in 2000 people – or approximately 200,000 people in European Union countries and 150,000 in the USA. It is characterised by a loss of clear boundaries between sleeping and waking states.

People with narcolepsy feel sleepy nearly all the time, and cannot resist going to sleep for a few minutes or up to an hour several times during the day. This abnormal propensity to sleep is referred to as Excessive Daytime Sleepiness by physicians. At night, their sleep is perturbed, with many awakenings and sometimes abnormally vivid dream-like hallucinations when falling asleep. Typically, they experience too little of the deep, restorative sleep that they need to feel fresh and alert in the morning. They are prone to sleep walking and sleep paralysis – an inability to move for a few minutes on waking.

About 9 out of 10 people with narcolepsy also have cataplexy – sudden muscle weakness that can range from drooping of the head and face to complete collapse. It is usually triggered by strong emotions, such as laughter, anger, surprise or fear, or by strenuous exercise.

Narcolepsy appears to result from an abnormal functioning of certain nerve transmitter chemicals in the brain that normally help to keep people awake. It often runs in families and tends to start when individuals are in their teens or 20s.

Narcolepsy treatment

Narcolepsy is usually diagnosed from symptoms of Excessive Daytime Sleepiness, cataplexy and night-time sleep disturbances, which can be confirmed by tests carried out in a sleep laboratory.

Establishing regular sleeping habits at night can help to reduce daytime tiredness, and taking ‘planned naps’ at convenient times during the day may reduce the number of sudden, uncontrollable urges to sleep that people with narcolepsy experience.

Some people take stimulant drugs during the day to keep them awake, but these may cause irritability and make it hard to sleep at night. Taking sleeping pills to improve sleep at night can leave people sleepy during the day.

Antidepressants are sometimes used to treat cataplexy, but with limited success. People become tolerant to treatment, so the doses have to be increased. Eventually, the effect may wear off altogether, forcing patients to switch to a different medication. Many antidepressants can have unpleasant side effects, including weight gain. Stopping antidepressant treatment suddenly can make the cataplexy worse. Therefore, the dose of antidepressants should always be reduced gradually rather than abruptly discontinuing.