Narcolepsy can develop at any age, but it commonly starts either during the teenage years or in middle age. A person with narcolepsy usually has the condition for life. All people with narcolepsy have extreme levels of sleepiness during the day, but how this shows itself can differ.
Symptoms often start in childhood, adolescence, or young adulthood (ages 7 to 25), but can occur at any time in life. Since people with narcolepsy are often misdiagnosed with other conditions, such as psychiatric disorders or emotional problems, it can take years for someone to get the proper diagnosis.
hormonal changes, including those that take place during puberty or the menopause. major psychological stress. a sudden change in sleep patterns. an infection, such as swine flu or a streptococcal infection.
There are 5 main symptoms of narcolepsy, referred to by the acronym CHESS (Cataplexy, Hallucinations, Excessive daytime sleepiness, Sleep paralysis, Sleep disruption). While all patients with narcolepsy experience excessive daytime sleepiness, they may not experience all 5 symptoms.
Things that have been suggested as possible triggers of narcolepsy include: hormonal changes, which can occur during puberty or the menopause. major psychological stress. an infection, such as swine flu, or the medicine used to vaccinate against it (Pandemrix)
Narcolepsy is characterized by uncontrollable excessive daytime sleepiness, paroxysmal cataplexy, sleep paralysis, and hallucinations. It is often misdiagnosed as psychiatric disorders such as depression and schizophrenia, resulting from the overlap in symptoms and a lack of understanding of narcolepsy.
Excessive daytime sleepiness is usually the first sign of narcolepsy. It can have a significant impact on everyday life. Feeling drowsy throughout the day and struggling to stay awake makes it difficult to concentrate at work or school. People with narcolepsy may be misjudged as being lazy or rude.
Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Your health care provider may recommend modafinil (Provigil) or armodafinil (Nuvigil). These medicines aren't as habit-forming as older stimulants.
Narcolepsy is often misdiagnosed as other conditions that can have similar symptoms, including: Depression. Anxiety. Other psychologic/psychiatric disorders.
You may feel a strong urge to sleep, often followed by a period of sleep. You can't control when you fall asleep. This is called a sleep attack. These periods can last from a few seconds to a few minutes.
There are barriers to narcolepsy diagnosis because it isn't as obvious as a broken arm. You may not know you keep falling asleep during the day, and friends and family might overlook it. It's important to see a specialist who can run thorough tests and exclude medical reasons for your sleep troubles.
Anxiety disorders, especially panic attacks and social phobias, often affect patients with narcolepsy. Anxiety and mood symptoms could be secondary complications of the chronic symptoms of narcolepsy. Recent studies have shown that narcolepsy is caused by defective hypocretin signaling.
Diagnosis of narcolepsy
A person with narcolepsy has excessive daytime sleepiness, with repeated episodes of sleep attacks, falling asleep involuntarily at inappropriate times, often several times every day. Narcolepsy can develop at any age, but it commonly starts either during the teenage years or in middle age.
Can You Wake Someone with Narcolepsy? While waking someone with narcolepsy does not present any health risks on its own, it may be very difficult. If you need to wake someone with narcolepsy for safety reasons, be aware that they may be confused and disoriented.
Stanford Sleep Specialists use two main tests to diagnose narcolepsy: the nocturnal polysomnogram and the multiple sleep latency test (MSLT). The polysomnogram continuously records brain waves during sleep, as well as a number of nerve and muscle functions during nighttime sleep.
The hallmark symptom of narcolepsy is an excessive daytime sleepiness (EDS), in which a person falls asleep at times when they want to be awake. EDS may include daytime sleep attacks that occur with or without warning, persistent drowsiness and fleeting moments of sleep that occur in between a person's waking state.
Rapid eye movement (REM) sleep is abnormal in narcolepsy. REM sleep is the active, dreaming phase of sleep. In fact, narcolepsy is sometimes defined as the loss of boundaries between wakefulness, non-REM sleep, and REM sleep.
Many people with narcolepsy report having symptoms starting between ages 10 and 20, but it can develop as late as age 40 to 50.
A Sleep Physician
Thorpy, the director of the Sleep-Wake Disorders Center at the Montefiore Medical Center in Bronx, NY, says that he recommends that narcolepsy patients be in bed for a minimum of eight hours each night, have a regular wake-up time, and hold these constant for two weeks.
You need to be medically able to drive, which includes being able to stay awake. The National Highway Traffic Safety Administration (NHTSA), the government agency that oversees highway safety, says that people with narcolepsy should only drive if they're on a treatment that helps them stay awake.
Possible causes of excessive daytime sleepiness. Some medicines, drinking too much alcohol and taking drugs can also cause excessive daytime sleepiness. Sometimes there is no known cause. This is called idiopathic hypersomnia.
You may also have a blood test to find out whether you have a genetic marker known as HLA DQB * 0602, which is associated with narcolepsy. A positive result supports a diagnosis, but does not make it 100% certain – 30% of people without narcolepsy also have the genetic marker.