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What is Narcolepsy? Flo Answers Your Questions About the Condition

Narcolepsy is a long-term sleeping disorder in which a person’s sleep-wake cycles are not regulated. The disorder is characterized by excessive sleepiness, brief involuntary sleep episodes, sleep paralysis, hallucinations, and sometimes cataplexy (sudden partial or total loss of muscle control). 

Type 1 narcolepsy is narcolepsy that occurs with cataplexy. Type 2 narcolepsy occurs without cataplexy.

Though the exact cause of narcolepsy is unknown, there are quite a few potential causes, including genetic predisposition, abnormal neurotransmitter functioning and sensitivity, and abnormal immune modulation.

Signs and symptoms of narcolepsy include: 

  • Excessive daytime sleepiness (EDS) — People with narcolepsy feel tired during the day regardless of how many hours they slept at night. They can fall asleep suddenly anytime or anywhere for a few minutes or up to half an hour. 
  • Fragmented nighttime sleep — Just as they have trouble maintaining wakefulness during the day, they have trouble maintaining sleep throughout the night. A person with narcolepsy will often wake 4–5 times per night and stay awake for up to 20 minutes at a time. 
  • Cataplexy — Cataplexy is a sudden loss of muscle control, often triggered by strong emotional reactions such as laughter, anger, surprise, or fear. The person remains conscious during the episode.
  • Sleep paralysis — Many people with narcolepsy experience sleep paralysis, which is the temporary inability to move or talk when drifting off or waking. 
  • Hypnagogic hallucinations — It’s common for people with narcolepsy to experience very vivid, frightening, dreamlike hallucinations as they’re falling asleep.
  • Changes in rapid eye movement (REM) sleep — REM sleep is when most dreaming occurs. People with narcolepsy typically transition into REM sleep very quickly and therefore, will experience vivid dreams when sleeping during the day, even for a few minutes at a time. 

After a nap during the day, a person with narcolepsy will usually feel refreshed, but the feeling is temporary.

The cause of narcolepsy is not completely understood. Research suggests that it’s usually the result of a combination of factors working together, which include:

  • Autoimmune disorders. An autoimmune disorder is when the immune system mistakenly attacks healthy cells and tissues. In narcolepsy, an autoimmune disorder may cause a loss of brain cells that produce the chemical hypocretin, which is responsible for promoting wakefulness and regulating REM sleep. 
  • Family history. About 10 percent of people diagnosed with Type 1 narcolepsy have a relative with similar symptoms. 
  • Brain injuries. Rarely, narcolepsy may be caused by a traumatic brain injury or a tumor that affects the part of the brain responsible for regulating wakefulness and REM sleep. 

There is no known cure for narcolepsy. Symptoms may be managed with medication, lifestyle changes, and support from family, friends, and mental health professionals. 

There are many things that people with narcolepsy can do to manage symptoms and improve their quality of life. These include both medication and lifestyle changes. 

Lifestyle changes recommended for those with narcolepsy include: 

  • Maintain good sleep habits, such as a strict sleep schedule that involves going to sleep and waking up at the same time each day and getting 7.5-8 hours of sleep. Limiting distractions in the bedroom and keeping the room at a comfortable temperature can also help. Scheduled naps during the day can prevent falling asleep suddenly in the middle of an activity.
  • Stay physically active. It’s important to exercise during the day, as it can improve your quality of sleep at night. Don’t exercise too close to bedtime — leave at least two hours between when you finish exercising and when you go to bed. 
  • Avoid eating heavy meals before bed. 
  • Avoid caffeine or alcohol before bed. 
  • Avoid driving or operating heavy machinery when sleepy. 
  • Never perform water activities solo. Wear a life preserver and ensure the people with you are aware of and prepared for cataplectic attacks. 

People with narcolepsy may be prescribed medications to help manage symptoms. Besides, a combination of lifestyle changes and prescription medication can help manage symptoms of narcolepsy. In addition, therapy or support groups can be beneficial for people with narcolepsy who are struggling to cope or are feeling socially isolated.

If you or a loved one has been diagnosed with narcolepsy, talk to your health care provider about medications, lifestyle changes, and therapy to help you cope. Sleep disorders are common, and you don’t have to go through this alone.

https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497

https://emedicine.medscape.com/article/1188433-overview#a3

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet

https://emedicine.medscape.com/article/1188433-treatment#showall

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