Sleep Disorders: Narcolepsy

Understanding Narcolepsy

Everyone has had experience with going to bed late or having a rough time trying to fall asleep, whether it be a late night out with friends, the struggle to fall asleep before a stressful day, or cramming before a big test. We all have an idea of how brutal daytime sleepiness can be, especially when there are other responsibilities like work or classes to attend to. But if you have narcolepsy, daytime sleepiness is something beyond your control.

Narcolepsy is a type of neurological disorder which affects your ability to control your sleep and stay awake. If you suffer from it, you will experience excessive levels of sleepiness during the day, as well as uncontrollable episodes of falling asleep during the day at any time.

During a typical sleep cycle, there are multiple stages of sleep: the early stages, deep sleep stages, and finally, rapid eye movement (REM) sleep. Sufferers of narcolepsy experience REM sleep almost immediately after the sleep cycle begins, and periodically during waking hours. REM is the period in which we experience dreams, and muscle paralysis, which is why narcolepsy causes some of its symptoms.

Narcolepsy can begin between the ages of 15 – 25, though it may appear at any age. Narcolepsy is often left undiagnosed and untreated.


Though the cause of narcolepsy is still unknown, scientists are beginning to identify genes associated with it. The current theory is that these genes control the production of chemicals in the brain which signal sleep and wake cycles. Some believe that it is caused by a deficiency in hypocretin production, a chemical which regulates the sleep and wake cycle, as well as bodily functions such as blood pressure and metabolism. There have also been discoveries of brain abnormalities in areas involved in regulating REM sleep, which contribute to the development of narcolepsy symptoms.


  • Excessive daytime sleepiness (EDS) which interferes with normal activities on a daily basis, regardless of how well the person has been sleeping. EDS brings a number of related symptoms with it, including mental cloudiness, lack of energy or concentration, memory lapses, a depressed mood, and/or extreme exhaustion.
  • Cataplexy is a sudden loss of muscle tone, causing feelings of weakness and loss of voluntary muscle control. Symptoms are slurred speech, total body collapse (depending on which muscles are involved), and is often triggered by intense emotions like surprise, laughter, and anger.
  • Hallucinations, which are delusional experiences typically vivid and frightening. Though primarily visual experiences, any of the other senses may be involved as well. They are called hypnagogic hallucinations when they are related to a sleep onset, or hypnopompic hallucinations if they appear while the person is awake.
  • Sleep paralysis is the inability to move or speak while falling asleep or waking up. Episodes typically last only a few seconds to several minutes at most. People rapidly recover their full capacity to move and speak afterward.


Unfortunately, there is no cure for narcolepsy itself. There are, however, medications that treat the most disabling symptoms, namely EDS and symptoms associated with abnormal REM sleep like cataplexy. Sleepiness is treated with amphetamine-like stimulants, and abnormal REM sleep symptoms are treated with antidepressants.

Recently, another medication has been approved for people suffering from narcolepsy with cataplexy called Xyrem. The drug helps people to sleep better and be more alert during the day.

If you have narcolepsy, you will need to make lifetime adjustments such as caffeine, alcohol, nicotine, heavy meals, regulating your sleep schedule, scheduling daytime naps (10 – 15 minutes long), as well as a normal exercise and meal schedule. These changes, together with proper medication, can substantially reduce the effects of narcolepsy symptoms.

Diagnosing Narcolepsy

Due to the large number of undiagnosed cases of narcolepsy, as well as a large number of symptoms shared in common with other conditions, narcolepsy can be difficult to diagnose without the help of a few tests run by a physician.

If you have been having trouble with chronic daytime sleepiness, give Dr. Shukla a call. Dr. Shukla is a pulmonologist specializing in asthma, allergies, and sleep disorders. With his 15 years of experience with thousands of other satisfied patients, he will be able to diagnose your condition properly and prescribe a treatment plan that will significantly improve your life.

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