Sleep Disorders:  
Obstructive Sleep Apnea
Narcolepsy
RLS/PLMD
Insomnia
Pediatric

Narcolepsy

Narcolepsy is a disorder of excessive sleepiness often occurring in episodes which may be associated with unusual symptoms and is typically diagnosed by excluding other sleep disorders and identifying specific findings on a study which consists of taking several naps.

What types of disorders are typically excluded before diagnosing narcolepsy?

Sleep apnea and periodic limb movement disorder are much more common than narcolepsy and should be excluded prior to making a diagnosis of narcolepsy. These can be excluded via an overnight sleep study although a sleep specialist may recommend alternative measures to exclude such disorders. Other obvious causes of sleepiness such as medications and insufficient sleep should also be explored.

What will the napping test show?

Known as a multiple sleep latency test this study consists of taking a series of naps. Falling asleep quickly and entering into specific sleep stages (REM sleep) are findings a sleep specialist will look for and evaluate prior to making a diagnosis of narcolepsy.

What unusual symptoms may be associated with this disorder?

Although not necessary to make a diagnosis the following symptoms indicate the possibility of narcolepsy:

Sleep Paralysis - Consists of the conscious experience of a paralyzed body typically occurring as one is transitioning into or out of sleep (i.e. awakening or falling asleep). This lasts a few seconds to minutes and can be quite frightening especially the first few times it is experienced. In some areas/cultures this may be referred to as being “ridden by the witch” or “the death grip”.

Hypnagogic hallucinations - Vivid frightening dream-like experiences occurring during the transition from sleep to wakefulness or wakefulness to sleep.

Cateplexy - If one has this symptom in conjunction with excessive sleepiness they most likely have narcolepsy. Cateplexy consists of the loss of muscle tone (weakness) provoked by strong emotion and lasting seconds to minutes. This weakness can range from subtle head droop, facial sagging or slurred speech to substantial weakness in the arms and legs leading to collapse.

Is there a simple blood test for narcolepsy?

A test exists which looks for a genetic marker found in almost all individuals with narcolepsy however this marker is also found in 25% of the general population thus severely limiting the usefulness of this test.

Can nighttime sleep be affected in narcolepsy?

Yes, sleep is often disrupted and fragmented during sleep.

What treatments are available for narcolepsy?

Treatments are briefly discussed based on the symptom/problem they treat:

Sleepiness - Behavioral intervention may be helpful such as following good sleep habits and taking planned naps but medication is almost always necessary. A common medication prescribed today is modafinil which is a wake-promoting agent for which additional information may be found at www.provigil.com. Other treatments include central nervous system stimulants such as Methylphenidate (Ritalin).

Disturbed Sleep - Sedatives may be recommended by a physician if nighttime sleep is sufficiently disrupted.

Cataplexy - Certain medications, most of which are considered antidepressants, have been found to be effective for many individuals.

Psychosocial dysfunction - For many narcolepsy can have a substantial and sometimes devastating impact on psychological, occupational, and social functioning. Counseling and support groups can be extremely helpful and accessed along with general information at the Narcolepsy Network.

For additional information on narcolepsy visit the Narcolepsy Network.

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