Narcolepsy Symptoms

What Is Narcolepsy?

Narcolepsy is a neurological disorder. It affects your brain’s ability to control your sleep-wake cycles. People with this disorder may feel the following [¹]:

• Rested after waking up
• Tired and sleepy throughout the day

Types of Narcolepsy

There are two types of narcolepsy. The first type is the most common. It involves the sudden loss of muscle tone. The name of this symptom is cataplexy. In this type, people may feel very sleepy during the daytime. This is because of low hypocretin levels in the brain. This protein regulates our appetite, wakefulness, and arousal.

The second type is without cataplexy. People with this type of narcolepsy have normal hypocretin levels.

How Is Narcolepsy Diagnosed?

Your healthcare provider diagnoses narcolepsy by assessing your symptoms [²]. They may inquire about your sleep history. They may also ask you to note down your sleep pattern for a few days. Some doctors also recommend wearing an “actigraph.” This device is like a watch that measures your rest and activity.

Some experts also conduct sleep studies or polysomnography. They place electrodes on your scalp. These electrodes measure signals during sleep. But the study may require you to spend a night at the facility. The test measures:

• Your breathing patterns
• Heart rate
• Brain waves
• Eye and leg movements, etc.

Some tests also measure how long you take to fall asleep during the day. One of them is the multiple sleep latency test. The professional may ask you to nap a few times at the sleep center. These naps are two hours apart. During the naps, the specialists watch your sleep patterns.

Some genetic tests help experts determine your risk of type 1 narcolepsy. They check your hypocretin levels in the spinal fluid.

Narcolepsy Staging

Neurolepsy doesn't have any stages. People with the disorder do not experience entirely different sleep stages. But there is a difference between people with and without narcolepsy. The latter group enters non-rapid eye movement before the rapid eye movement stage. The former falls immediately into REM sleep.

Is Narcolepsy Hereditary?

The condition does not have a clear genetic pattern. Most of its cases occur with no previous family history. Only a small percentage of cases had a family history. First-degree relatives of those with the condition have a 40 times higher risk of getting it [³].

Narcolepsy Symptoms

Not everyone with narcolepsy has the same symptoms. People also don’t have all symptoms at the same time. But if you have the following persistently, consult a doctor immediately.

What Are the Symptoms of Narcolepsy?

The four main symptoms of narcolepsy are [⁴]:

Daytime sleepiness

It's normal to want to sleep during the daytime in some cases. But if the need is there excessively, it may be a problem. Experts also call it "sleep attacks."

Sleep paralysis

It isn’t always common. But sleep paralysis can be terrifying. In this state, you’re awake but not fully. You’re also unable to move.

Cataplexy

Sudden muscle weakness may affect one side of your body. This symptom has mild effects.

Hallucinations

Sleep-related hallucinations can happen:

• Right before waking up or
• Right after falling asleep

What Are Some Signs of Narcolepsy?

Additional signs of narcolepsy include:

• Excessive tiredness and need to sleep during the day
• Problems related to inadequate sleep
• Lack of energy
• Memory problems
• Trouble focusing, etc.

Symptoms of Narcolepsy in Women vs. Symptoms of Narcolepsy in Men*

A study tested the differences between narcolepsy in men and women. It concluded [⁵]:

• Men and women have similar symptoms in most cases.
• Women get a diagnosis after a delay.
• Women have the condition but stay without a diagnosis for long.
• They also reported more objective sleepiness on a test.
• Women did not report any lifestyle impairments
• Their personal relationships stayed normal
• But they self-medicated with caffeine

All in all, the condition impacts both genders differently.

Risk Factors for Narcolepsy

The following factors can increase your risk of narcolepsy:

• Environment
• Family history

Sometimes it also occurs due to other medical conditions. The condition may be more common in men than in women. Other risk factors include:

• A stroke
• A head injury
• Sarcoidosis
• Upper airway infection

Narcolepsy Prevention

Prevention isn't possible, but management is [⁶]. Treatment can reduce the number of attacks. Practicing healthy sleeping habits can reduce complications. Plan your naps accordingly. Make sure to schedule them only during the day.

Narcolepsy Prognosis and Treatment

It is a lifelong problem. But without treatment, you will suffer psychosocially. You may experience poor work performance, social impairment, and much more. You will also experience excessive tiredness. It will hinder your ability to perform daily functions.

Narcolepsy Survival Rate

Narcolepsy does not pose a direct threat to your health. Over time, it may hinder your daily functioning. A study concluded that the mortality rates are higher in those with the condition. In 2008, the rate was 1.14%. In 2009, it was 1.17%. In 2010, it was 1.16%. The non-narcolepsy population had the following rates [⁷]:

• 0.78%
• 0.77%
• 0.79%

So the condition does not threaten your survival. But the complications can cause physical deterioration over time.

Narcolepsy Treatment Options

Doctors can treat narcolepsy. But they cannot cure it. Treatments start with medications. Doctors also recommend making lifestyle changes.

Most medications work to reduce daytime sleepiness. Some medications also target other symptoms. But they are the first line of treatment.

For example, the following medications reduce your daytime sleepiness frequency:

• Armodafinil
• Modafinil

They also reduce the severity of this symptom. The following drugs are also helpful. But you should only use them after your doctor’s approval.

• Ritalin
• Adderall
• Concerta
• Qullivant

Certain antidepressants can also help with the sleep cycle. These may include:

• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Selective serotonin reuptake inhibitors (SSRIs)

Sodium oxybate can also improve your sleep. But many countries regulate it tightly. This is because it has some detrimental effects. Some places still use it to treat type 1 narcolepsy.

Some drugs work by blocking chemicals in your body from attaching to cells. One such class of drugs is the “histamine-affecting drugs.” Pitolisant is a prominent medicine in this class. It is a histamine receptor antagonist.

It’s important not to self-medicate. Narcolepsy drugs can interact with other drugs. They can cause side effects such as:

• Irregular heartbeat
• High blood pressure, etc.

Sodium oxybate is also dangerous if it combines with other drugs. You should avoid having any of these medications with alcohol.

There are many treatments for adults. But the options for children are limited. Only a child’s pediatrician can prescribe the right medication for them. Similarly, adults must also rely on their healthcare providers. Only they can educate you about the following:

• The right medication for your condition
• The side effects of those medications
• Drug interactions
• Food and beverages to avoid, etc.

Conclusion

Takeaway

All in all, never self-diagnose or self-treat the condition. Many narcolepsy symptoms are similar to symptoms of:

• Epilepsy
• Sleep apnea

While it isn't dangerous, it can cause serious complications. It may affect your ability to drive or even swim. Understanding the underlying causes is the first step to managing them. But make sure not to delay your diagnosis and treatment. The condition does not get worse over time. But its complications can become difficult to deal with.