Health A-Z

Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness, sudden loss of muscle tone (cataplexy), hallucinations, and sleep paralysis. It's a relatively rare condition, affecting about 1 in 2,000 people. Here's an overview of the symptoms, treatment options, and diagnosis testing related to narcolepsy.

1. Excessive Daytime Sleepiness (EDS): Individuals with narcolepsy experience persistent daytime sleepiness, regardless of the amount of nighttime sleep they get.
2. Cataplexy: Cataplexy is sudden, brief episodes of muscle weakness or paralysis triggered by strong emotions such as laughter, excitement, or anger. It can range from mild muscle weakness to complete collapse.
3. Sleep Paralysis: Sleep paralysis involves temporary inability to move or speak while falling asleep or waking up. It may be accompanied by hallucinations.
4. Hallucinations: Narcolepsy can cause vivid hallucinations, often occurring when falling asleep (hypnagogic hallucinations) or waking up (hypnopompic hallucinations).
5. Disrupted Nighttime Sleep: Some individuals with narcolepsy may also experience disrupted nighttime sleep, characterized by frequent awakenings or difficulty maintaining sleep.

1. Stimulant Medications: Stimulant medications such as modafinil and armodafinil are often prescribed to help reduce daytime sleepiness and improve alertness.
2. Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs, antidepressant medications such as fluoxetine and venlafaxine, may be used to manage cataplexy and other symptoms of narcolepsy.
3. Sodium Oxybate (Xyrem): Sodium oxybate is a central nervous system depressant that can help improve nighttime sleep quality and reduce cataplexy episodes.
4. Lifestyle Modifications: Establishing regular sleep habits, taking scheduled naps, and avoiding caffeine and alcohol close to bedtime can help manage symptoms of narcolepsy.
5. Supportive Therapies: Behavioral therapies, such as cognitive-behavioral therapy for insomnia (CBT-I) and counseling, can help individuals cope with the emotional and psychological impact of narcolepsy.

1. Clinical Evaluation: A healthcare provider will conduct a thorough medical history and physical examination to assess symptoms and rule out other potential causes of excessive daytime sleepiness.
2. Sleep Studies: Polysomnography (PSG) and multiple sleep latency test (MSLT) are the primary tests used to diagnose narcolepsy. PSG measures various physiological parameters during sleep, while MSLT evaluates daytime sleepiness by measuring how quickly an individual falls asleep during scheduled naps.
3. Measurement of Hypocretin Levels: Low levels of hypocretin (also known as orexin), a neurotransmitter involved in regulating wakefulness, are associated with narcolepsy type 1. A cerebrospinal fluid (CSF) sample may be collected via lumbar puncture to measure hypocretin levels.