Narcolepsy

Narcolepsy is a rare sleep disorder that affects the brain’s ability to regulate sleep-wake cycles, causing chronic daytime sleepiness. Narcolepsy can cause sleepiness so severe that a person may nod off without warning — in the middle of a conversation, cooking a meal or crossing the street.

Left untreated, narcolepsy can interfere with your daily routines, disrupt personal relationships and cause problems with mood. It can also increase the risk of accident or injury, since overwhelming sleepiness can strike at any time. MultiCare’s sleep medicine specialists partner with you to treat your symptoms so you can focus on leading a full life.

Symptoms of narcolepsy

Symptoms vary from person to person and typically first appear between 15 and 25 years of age. Common signs of narcolepsy include:

• Excessive daytime sleepiness
• Irresistible urges to fall asleep at inappropriate times, also known as “sleep attacks”
• Disturbing hallucinations while falling asleep or just waking up
• Sleep paralysis — inability to move or speak while falling asleep or waking
• Cataplexy — sudden, temporary muscle weakness in response to strong emotions, such as laughter or excitement
• Frequent night-waking
• Trouble thinking or concentrating during the day

Risk factors and causes of narcolepsy

Narcolepsy does not have one definitive cause. However, a common culprit is a low level of hypocretin — a protein in the brain that is responsible for alertness and helps regulate sleep. According to the National Institute of Neurological Disorders and Stroke, a number of factors may converge to cause low hypocretin levels. Those include:

• Autoimmune disorders. Autoimmune disorders cause a person’s immune system to attack healthy tissue. In some cases, the immune system may attack the brain cells that contain hypocretin, disrupting the production of this protein. Certain infections, such as streptococcal infections, have also been linked to an increased risk of narcolepsy, possibly due to an autoimmune response triggered by the infection.
• Genetics. Researchers have identified a number of gene mutations (changes) that are associated with narcolepsy, though the presence of a particular gene mutation does not necessarily mean a person will go on to develop narcolepsy. Often these gene mutations are random rather than inherited; however, individuals with a family history of narcolepsy may also be at a higher risk.
• Brain injuries. Traumatic brain injuries or other damage to the hypothalamus, the region of the brain involved in regulating sleep and wakefulness, may increase the risk of narcolepsy.

Diagnosing and treating narcolepsy

Narcolepsy is a lifelong condition, but symptoms can be treated. If you suspect you have narcolepsy, you may need to undergo a sleep study in one of MultiCare’s state-of-the-art sleep centers. Our board-certified sleep specialists will analyze your study results and work with you to develop a treatment plan.

Treatments vary depending on the cause and severity of narcolepsy, as well as your overall health. Common treatments include:

• Taking medications. A combination of medications, such as stimulants, wake promoting agents, or certain antidepressants, can be effective at controlling symptoms. Your sleep specialist will discuss these options with you.
• Improving sleep hygiene. Forming habits that support sleep, such as establishing a relaxing bedtime routine and limiting evening screen time, can improve sleep quality.
• Napping. Consistently incorporating scheduled naps into your daily routine can help alleviate daytime sleepiness.