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Narcolepsy

Daytime sleep disorder; Cataplexy

Narcolepsy is a nervous system problem that causes extreme sleepiness and attacks of daytime sleep.

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Sleep patterns in the young and aged

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Causes

Experts aren't sure of the exact cause of narcolepsy. It may have more than one cause.

Many people with narcolepsy have a low level of hypocretin (also known as orexin). This is a chemical made in the brain that helps you stay awake. In some people with narcolepsy, there are fewer of the cells that make this chemical. This may be due to an autoimmune reaction. An autoimmune reaction is when the body's immune system mistakenly attacks the body's healthy tissue.

Narcolepsy can run in families. Researchers have found certain genes linked to narcolepsy.

Symptoms

Narcolepsy symptoms usually first occur between age 15 and 30 years. Below are the most common symptoms.

EXTREME DAYTIME SLEEPINESS

CATAPLEXY

HALLUCINATIONS

SLEEP PARALYSIS

Most people with narcolepsy have daytime sleepiness and cataplexy. Not everyone has all these symptoms. Surprisingly, despite being very tired, many people with narcolepsy don't sleep well at night.

There are two main types of narcolepsy:

Exams and Tests

Your health care provider will do a physical exam and ask about your symptoms.

You may have a blood test to rule out other conditions that can cause similar symptoms. These include:

You may have other tests, including:

Treatment

There is no cure for narcolepsy. However, treatment can help control symptoms.

LIFESTYLE CHANGES

Certain changes can help improve your sleep at night and ease daytime sleepiness:

These tips can help you do better at work and in social situations.

If you have narcolepsy, you may have driving restrictions. Restrictions vary from state to state. Your provider may recommend that you avoid driving or other activities, depending on how well your symptoms are controlled.

MEDICINES

These drugs may have side effects. Work with your provider to find the treatment plan that works for you.

Outlook (Prognosis)

Narcolepsy is a lifelong condition.

It may be dangerous if episodes occur while driving, operating machinery, or doing similar activities.

Narcolepsy can usually be controlled with treatment. Treating other underlying sleep disorders can improve narcolepsy symptoms.

Possible Complications

Excessive sleepiness due to narcolepsy may lead to:

When to Contact a Medical Professional

Contact your provider if:

Prevention

You can't prevent narcolepsy. Treatment may reduce the number of attacks. Avoid situations that trigger the condition if you are prone to attacks of narcolepsy.

Related Information

Drowsiness

References

Avidan AY. Sleep and its disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 101.

Krahn LE, Hershner S, Loeding LD; American Academy of Sleep Medicine, et al. Quality measures for the care of patients with narcolepsy. J Clin Sleep Med. 2015;11(3):335. PMID: 25700880 pubmed.ncbi.nlm.nih.gov/25700880/.

Maski K, Guilleminault C. Narcolepsy: diagnosis and management. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 112.

Mignot E. Narcolepsy: pathophysiology and genetic predisposition. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 111.

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Review Date: 8/28/2023  

Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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