Diseases, Disorders, & More: Narcolepsy

Ally Leinart, Head of Photography
October 4, 2021

Also Known As

  • Gelineau’s Syndrome
  • Hypnolepsy
  • Narcoleptic Syndrome
  • Paroxysmal Sleep

Symptoms

  • Cataplexy, sudden muscle weakness while awake or with strong emotions
  • Hallucinations just before falling asleep or waking up
  • Episodes of Paralysis

Subdivisions

  • With Cataplex
  • Without Cataplexy

General Overview

  • Neurological Sleep Disorder
    • Chronic, excessive attacks of drowsiness during the day, sometimes called EDS, Excessive Daytime Sleepiness.
    • Few seconds – Several minutes
    • Vary in frequency
      • Few incidents – Several times a day
      • Nighttime patterns could be disrupted
    • May be associated with “automatic behavior”
      • Having no memory of doing things
    • 1 in 2000 people are diagnosed with  narcolepsy
    • Believed to be undiagnosed/misdiagnosed in most individuals
  • Evidence points to being Autoimmune Disorder
    • Body destroys brain cells that produce a peptide called hypocretin
    • Details are not known yet
  • Environmental and Genetic factors may play a role in development

Onset

  • Anywhere from early childhood to 50 years of age
    • Peaks around 15 and 36
    • Underdiagnosed in children 
    • Remains a lifelong condition
    • Not progressive
      • Symptoms can change in severity

Diagnosis

  • Clinical Evaluation
  • Two tests
    • Polysomnogram(PSG)
    • Multiple Sleep Latency Test(MSLT)
  • Testing of Cerebrospinal fluid for hypocretin levels

Treatments

  • Directed towards specific symptoms
    • Daytime Sleepiness and Sleep Attacks
      • Stimulants
      • Modafinil
        • FDA Approved
        • Fewer side effects than previous drugs used
    • Cataplexy
      • Xyrem
        • Also good in improving nighttime sleep
        • Serious side effects, like slowed/stopped breathing 
    • Sleep Paralysis and Hypnagogic Hallucinations
      • Certain Antidepressants
        • Prozac, Sarafem, Zoloft, Strattera, and Effexor
        • Low risk side effects
  • Behavioral Modifications
    • Sleep satiation and scheduled naps to reduce daytime sleep attacks
    • systematic desensitization and stimulus control to lessen cataplexy episodes
    • imagery rehearsal therapy to reduce the frequency of and cope with hypnagogic hallucinations
    • hypnosis to decrease the severity of sleep paralysis
    • cognitive therapy to reduce adverse effects stemming from dysfunctional cognitions
    •  muscle relaxation to manage anxiety that can worsen narcolepsy symptoms
    •  diet schedule that optimizes alertness and functioning throughout the day and the quality of nighttime sleep

Similar/Related Disorders

  • Idiopathic Hypersomnia
  • Sleep Apnea
  • Kleine-Levin Syndrome
  • Brain Tumors
  • Head Trauma
  • Cerebral Arteriosclerosis
  • Psychosis
  • Excessive amounts of Protein in blood due to kidney failure

 Resources