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What is narcolepsy?

man sleeping
Narcolepsy is a disorder which can cause people to fall asleep at inappropriate times. But what are the causes? And is there a treatment? Learn more.

Sometimes misunderstood, narcolepsy is a rare sleep disorder that affects the brain’s ability to manage your sleep-wake processes.

Narcolepsy is a long-term condition where your brain fails to regulate regular sleeping and waking patterns. This can cause you to fall asleep randomly and unwillingly at inappropriate times, like when eating, talking, or even driving.

It is thought to affect around 30,000 people in the UK, but many people may be undiagnosed.1

It generally doesn’t cause any serious health problems but can sometimes be dangerous and challenging to deal with emotionally as it can impact daily activities.

So, what are narcolepsy symptoms, and is there a narcolepsy treatment?

We’ll tell you all you need to know and more in our article below.

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What are the symptoms of narcolepsy?

Narcolepsy symptoms vary from person to person and can develop over time or more suddenly over a short period.

Some people may experience symptoms of narcolepsy frequently, whilst others might just experience them occasionally.

Narcolepsy symptoms include:

Excessive daytime sleepiness

The most common symptom of narcolepsy is excessive daytime sleepiness (EDS).

This happens when the brain is unable to regulate sleepiness and wakefulness, so you’ll likely feel an irresistible urge to sleep during everyday activities, regardless of how much sleep you got the night before.  

EDS can mean you end up falling asleep anywhere, even whilst eating or talking. It can also have a tangible impact on your day-to-day life, impacting your ability to maintain your attention at work or school.2

Usually, if you take a nap during the day, you’ll feel temporarily refreshed, but over time, you will begin to feel drowsy and sleep again.

 

Sleep attacks

Perhaps one of the most alarming narcolepsy symptoms, a sleep attack is when you feel an overwhelming feeling of sleepiness and will fall asleep suddenly and unwillingly at any time.3

A sleep attack can last from a few seconds to a few minutes but can be particularly dangerous if you are driving or operating heavy machinery.

 

Cataplexy

Narcolepsy with cataplexy is also really common.

Cataplexy is the sudden weakness or loss of muscle control that is often triggered by a sudden emotion like excitement or laughter.

Cataplexy can last from a few seconds to a few minutes, with some people experiencing it regularly and some experiencing it just once or twice a year.

The signs of cataplexy include your jaw dropping, your head slumping down, your legs collapsing uncontrollably, your speech slurring and your eye having trouble focusing.4

But cataplexy can be mild and only involve slight effects like the drooping of your eyelids or minor muscle weakness.3

 

Sleep paralysis

Some people with narcolepsy may experience sleep paralysis.

Sleep paralysis is the temporary inability to move your muscles when falling asleep or waking up, likely because your body is in sleep mode, but your brain is active.5

It is similar to cataplexy but will occur when falling asleep or waking up as opposed to during the day.

You might feel like you are awake but can’t move or speak. This brief loss of muscle control is known as atonia and can last from a few seconds to a few minutes.6

 

Hallucinations

With narcolepsy, you may experience hallucinations too that can sometimes be very vivid, real, and frightening visions.

Sometimes, these hallucinations can accompany sleep paralysis and happen when you are falling asleep or just waking up.3

 

Restless sleep

Another very common symptom of narcolepsy is experiencing interrupted sleep, including nightmares, hot flashes, and even waking up frequently.4

 

What are the different types of narcolepsy?

There are two types of narcolepsy:

  • Type 1 Narcolepsy (NT1)

Formerly known as narcolepsy with cataplexy, NT1 is associated with the loss of neurons in the brain that make a hormone called hypocretin and cataplexy symptoms like muscle weakness.3  

Hypocretin helps to regulate sleep and wakefulness, but with NT1, some may lose up to 90% of these essential hypocretin-making neurons.7

In some cases, a loss of these neurons has been linked to autoimmune diseases, but it is also thought that genetics plays a significant role, too.8,9

  • Type 2 Narcolepsy (NT2)

Those with NT2 often experience excessive daytime sleepiness but generally won’t experience cataplexy symptoms.

Generally, people with NT2 will experience less intense symptoms and often have normal hypocretin levels.10

Why does narcolepsy occur?

There are many causes of narcolepsy, but most research points to a lack of hypocretin.

Scientists have found that a lack of hypocretin can be linked to an autoimmune response, where the immune system mistakenly attacks healthy cells and tissue that produce hypocretin.11

With low levels of hypocretin, the brain can struggle to distinguish between sleep and wakefulness and will be less able to regulate sleep cycles.

But in some cases, like with NT2, hypocretin levels remain normal, so determining the exact cause can be challenging.

What are the causes of narcolepsy?

It is thought that some factors can cause or increase the risk of narcolepsy.

Some narcolepsy causes include:11

  • Genetics & family history
  • Autoimmune disorders
  • Hormonal changes
  • Intense psychological stress
  • An infection
  • Injuries to the brain
  • A major change in sleep patterns

How to treat narcolepsy

There is currently no cure for narcolepsy, but following diagnosis, there are treatment options that can help reduce symptoms, improve quality of life, and improve safety.

For many people, narcolepsy remains stable throughout their lives, and some symptoms can even improve as they get older or even go away completely.12,13

Narcolepsy treatment often includes a combination of making lifestyle changes and medication. Some of the lifestyle changes may include:14

  • Planning short naps during the day to reduce excessive daytime sleepiness
  • Creating good sleep habits, like a consistent schedule and a good sleep environment
  • Cutting out alcohol as it can lead to more sleepiness
  • Eating a balanced diet
  • Exercising regularly
  • Seeking support from groups and professionals

The bottom line

As it’s a long-term brain condition, many people may struggle with narcolepsy and its symptoms. It can be emotionally and physically difficult, but understanding why it might happen and recognising the signs of narcolepsy can help you to cope with it.

There are treatment options available, from medication to lifestyle changes, that can help you live a normal, healthy life.

If you feel you are struggling, please speak to a medical professional who will help you with effective treatment and lifestyle changes to manage your symptoms.

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle. 

Last updated: 18 January 2023

Sources

  1. https://www.nhs.uk/conditions/sleep-apnoea/
  2. https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090
  3. https://en.wikipedia.org/wiki/Central_sleep_apnea
  4. https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109
  5. https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea
  6. https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090
  7. https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea
  8. https://en.wikipedia.org/wiki/Sleep_apnea#Risk_factors
  9. https://www.sleepfoundation.org/articles/menopause-and-sleep 
  10. https://www.winchesterhospital.org/health-library/article?id=20180 
  11. https://www.cedars-sinai.org/programs/pain-center/conditions-treatments/sleep-apnea.html
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793876/
  13. https://pubmed.ncbi.nlm.nih.gov/20073373/
  14. https://www.sleepapnea.org/treat/sleep-apnea-treatment-options/sleep-apnea-surgery/
 

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