Narcolepsy

Medically reviewed by Valerie Cacho, MD, board-certified sleep medicine physician

 

In short: Narcolepsy is a lifelong neurological condition in which the brain has trouble keeping sleep and wakefulness in their proper lanes. The hallmark is overwhelming daytime sleepiness, sometimes with sudden "sleep attacks," even after a full night in bed. Symptoms often begin in the teens or twenties, and many people go years before getting the right diagnosis.

 

Common signs

• Excessive daytime sleepiness that makes it hard to stay awake at work, school or the wheel

• Cataplexy: sudden muscle weakness, such as a sagging face, buckling knees or slurred speech, often set off by laughter or strong emotion

• Sleep paralysis: briefly being unable to move or speak while falling asleep or waking

• Vivid hallucinations at the edge of sleep

• Broken, restless sleep at night

 

Type 1 and type 2

In type 1, most people have cataplexy, and the brain makes too little hypocretin (orexin), a chemical that helps keep us awake and regulates REM sleep. People with type 2 usually do not have cataplexy, and hypocretin levels are typically normal.

 

How we diagnose and treat it

Diagnosis usually involves an overnight sleep study followed the next day by a multiple sleep latency test (MSLT), which measures how quickly you fall asleep and enter REM sleep during scheduled naps.

 

There is no cure yet, but treatment can make a big difference. Plans often combine wake-promoting and other prescription medications with scheduled short naps and a steady sleep routine. Several narcolepsy medications require insurance prior authorization, and our team helps you through that process.

 

Sleepy no matter how much you sleep?

Book an appointment in person in Fullerton, Los Alamitos or Ewa Beach, or by telehealth anywhere in California and Hawaii. Call (657) 553-3799 in California or (808) 500-7077 in Hawaii.

 

Source: Mayo Clinic, "Narcolepsy." This page is for education only and is not a substitute for a medical evaluation.