What is Narcolepsy?
Narcolepsy is a rare long-term disorder, which makes a person involuntarily fall asleep during the day. People with narcolepsy can also have excessive day time sleepiness, and other issues related to sleep. Narcolepsy can have an impact on many aspects of daily life, including education, employment, driving, relationships and emotional health.
- Narcolepsy is rare, and affects about 1 in 2,500 people
- Research suggests that there are little gender differences for narcolepsy, which means that
men and women are affected equally
- Narcolepsy is often thought of as a sleep disorder because of its symptoms, however due to
its underlying cause it can be better classed as a disorder of the central nervous system
What causes it?
There are two types of narcolepsy – primary narcolepsy and secondary narcolepsy. Primary narcolepsy is caused by a lack of a brain chemical called hypocretin (or orexin). This chemical regulates how awake you feel. The lack of this chemical is thought to occur due to an autoimmune reaction – which means that your body’s defence cells attack the cells that produce it or the cells that allow it to work. There are other causes of narcolepsy that include hormonal changes, severe psychological stress, an infection or a reaction to medication. Secondary narcolepsy can develop after damage to the brain, such as a head injury, a brain tumour, multiple sclerosis (MS) and encephalitis.
What are the symptoms?
Not everyone with narcolepsy has the same symptoms, and there can be different frequencies of symptoms. Symptoms can occur at any stage of life, but often start in childhood and adolescence. Some symptoms include: excessive daytime sleepiness, sleep attacks (falling asleep without warning), sleep paralysis and cataplexy (sudden muscle weakness/loss of muscle control). Narcolepsy can also lead to other symptoms such as hallucinations, memory problems, headaches, restless sleep, automatic behaviour and depression.
How is it diagnosed?
If a person thinks that they may have narcolepsy, they will usually make an appointment with their GP, who will look at family history and medical records. The GP will ask about sleep habits, and other symptoms, then proceed to rule out other conditions through physical exams and blood tests. It may be useful to complete a sleep diary and a sleep questionnaire. The GP may then refer the patient on to a sleep disorder specialist, in order to analyse your sleep. This can be done via questionnaires, polysomnography, multiple sleep latency tests and also by measuring hypocretin levels via a lumbar puncture.
How is it treated?
There is no specific cure for narcolepsy, but there are ways to manage symptoms. For mild cases, changing sleeping habits may benefit an individual’s condition. For example; taking frequent and brief naps, having a strict bedtime routine, relaxing before bed, avoiding caffeine, not exercising close to bed time, and not eating large meals before bed. Talking therapies may also be beneficial, as narcolepsy can be a difficult disorder to live with. This can be one on one with a therapist or social worker, or via support groups where there are others with the condition present. For more severe cases, medication may also be prescribed, such as stimulants, anti-depressants and sodium oxybate. Children and young people at school or in education may benefit from extra support, and a schedule in place for napping during the day. Adults with narcolepsy could benefit from informing their employer, which could allow them to implement similar support strategies to help manage their condition.
Want to know more?
Narcolepsy UK: https://www.narcolepsy.org.uk
The National Sleep Foundation: https://sleepfoundation.org/sleep-disorders-problems/narcolepsy-and-sleep