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Narcolepsy - Symptoms, Treatment and Medication

So, What Is Narcolepsy Exactly?

Narcolepsy is a condition that causes abnormal and uncontrollable sleep patterns. The illness highly affects the nervous system.

The good news is that is a very rare condition. According to experts, only 1 in 2000 people suffer from this uncommon chronic condition.

Also, Narcolepsy affects both males and females equally.

The first early symptoms of narcolepsy usually trigger between the ages of 10 and 25. However, the condition is often misdiagnosed due to it’s scarcity.

Generally, narcolepsy causes you to be very drowsy throughout the day, creating overwhelming urges to get some sleep.

The more severe cases include so called “sleep attacks”. This is when people uncontrollably fall asleep as they go about their day. This is the most dangerous element of the condition.

These sleep attacks occur unexpectedly and lead to a temporary loss of muscle control. This is also called cataplexy.

Very often, this is misdiagnosed as a seizure – especially in children.

While narcolepsy itself isn’t deadly, unfortunate episodes may lead to accidents, some of which may be life threatening.

Imagine losing consciousness and muscle control while driving – please be very careful, especially if you suspect to suffer from narcolepsy.

All of these factors have a massive negative effect on people’s quality of life. Many find it difficult to maintain jobs, relationships or studies due to excessive sleepiness during the day.

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Narcolepsy and REM Sleep

What is often misunderstood is that people with narcolepsy don’t sleep more than we do. They only (partially) lose the ability to control the time when they do.

As a consequence, many narcoleptics have poor quality sleep during the night. Very often it is fragmented as it skips or splits the required REM cycles throughout the entire day.

A normal good night’s sleep for adults begins with NREM (non-rapid eye movement) sleep, followed by REM (rapid eye movement) sleep. The latter is what we usually refer to as deep sleep.

People suffering from narcolepsy almost immediately enter REM sleep. Very often, the first NREM sleep stages are completely skipped.

These stages are important since they are what tells your body to calm down and relax. It lowers your breathing and heart beat while relaxing your muscles.

In addition, narcolepsy is often associated with sleep paralysis and hallucinations. This is because during the involuntary REM sleep, your muscles are paralyzed and you dream.

Types of narcolepsy

There are three types of narcolepsy, conveniently called type 1, type 2, and secondary narcolepsy!

Type 1 Narcolepsy

This was initially called narcolepsy with cataplexy. This diagnosis is based on low levels of the brain hormone called hypocretin.

Alternatively, individuals also report experiencing cataplexy and heavy daytime sleepiness.

Type 2 Narcolepsy

This was initially called narcolepsy without cataplexy. Between the two, this is considered the less severe one.

People with type 2 narcolepsy experience heavy daytime sleepiness without the muscle weakness or paralysis.

In addition, they often have normal levels of hypocretin and far fewer occurrences.

Secondary Narcolepsy

This can be a result from an injury to the hypothalamus. It is the region of the brain that helps to regulate your sleep patterns.

Apart from the usual symptoms of narcolepsy, people may find themselves sleeping for very long periods at a time. Many exceed the 10 hours each night.

In addition, some also report to have severe neurological problems.

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Narcolepsy Symptoms

There are 8 primary symptoms of narcolepsy.

People experience these symptoms differently, both in frequency and severity.

They may also develop very suddenly or over a few years.

Let’s take a look at the symptoms of narcolepsy!

Excessive Daytime Sleepiness

One of the first signs and symptoms of narcolepsy is usually excessive daytime sleepiness.

Many report feeling extremely exhausted and drowsy throughout the day.

Even though they had enough sleep the night before, it is simply difficult to stay awake.

People with excessive daytime sleepiness find it difficult to concentrate and fully function, which can interfere with their daily activities.

They are often misunderstood as being lazy or rude.

Sleep Attacks

Sleep attacks are also one of the common signs and symptoms of narcolepsy.

People with narcolepsy tend to fall asleep suddenly.

This happens without any warning, during any activity, and at any time or place.

Sleep attacks often occur after eating and can be short or long lasting.

For some, they only last a few seconds to a few minutes. For others, they can even go up to 30 minutes.


Cataplexy is a sudden and temporary loss of muscle control while being awake.

About a third of people with narcolepsy experience cataplexy.

However, it is a symptom which usually develops itself in the later stages of the condition.

It is often triggered by intense emotions, such as laughter, excitement, surprise or anger.

This leads to many becoming emotionally withdrawn and socially isolated as they attempt to avoid attacks.

Just as a sleep attack, the duration of a cataplexy attack varies from person to person.

They usually last from a few seconds to several minutes.

The frequency varies as well. Some have it once or twice a year, while it may be a daily occurrence for others.

This symptom involves certain muscle groups which may even result in the affected person collapsing or falling.

People also report slurred speech and blurred vision during such episodes.

The usual muscle groups include:

  • Jaw
  • Head
  • Legs
  • Mouth
  • Eyes

Sleep Paralysis

Sleep paralysis is the temporary inability to move or speak as you wake up or are falling asleep.

However, you are fully conscious during an episode.

These episodes can last anywhere from a few second to several minutes.

While it doesn’t cause any direct harm, the experience is an extremely frightening one.

The moment it ends, people will have no problems to speak and move again.

Many are fully conscious of what happened and have no issues in recalling the experience afterwards.

Hypnagogic Hallucinations

Hallucinations can be vivid, realistic, bizarre, and are often very frightening.

They are dream-like experiences between the real world and the dream world.

When they occur as you fall asleep, they are called hypnagogic.

If you experience this as your wake up, they are called hypnopompic.The experience is usually visual.

However, other senses may also be involved depending on the severity.

Disrupted Nighttime Sleep (DNS)

While people with narcolepsy don’t have troubles falling asleep, they experience distrupted sleep during the night.

DNS is the inability to stay asleep for more than a few hours at a time. People wake up multiple times throughout the night.

They are mainly caused by vivid dreams, periodic leg movements or sleep talking.

This results in people feeling tired and unenergized in the morning.

Automatic Behavior

Some people carry on with an activity without being aware of what they are doing. Many won’t even be able to recall it afterwards.

For example, if you were typing something up on your laptop, you may continue hitting random letters.

While you continue to function, you are simply unaware of your actions and aren’t performing them well either.

Memory Lapses

Some people experience difficulty in remembering recent events, actions or words.

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Narcolepsy Causes

So, what are the causes of narcolepsy?

Scientists haven’t been able to find the cause of narcolepsy just yet.

However, low levels of the brain chemical called hypocretin (orexin) seems to be connected to narcolepsy.

Hypocretin is the neurotransmitter that helps regulate wakefulness and REM sleep.

There are 2 suspicions about the origin of low hypocretin:

Immune System and Narcolepsy

Some experts suspect that it is a form of auto-immune disease. This is when your own immune system is attacking friendly parts of your body instead of solely destroying disease carrying organisms and toxins.

In this case, the immune system may mistakenly attack healthy parts of the brain. This may explain the lack of hypocretin production.

However, it doesn’t explain causes for narcolepsy without cataplexy, nor narcolepsy with normal levels of hypocretin.

Inherited Narcolepsy

About 10% of people with narcolepsy have reported to have close relatives with similar symptoms.

In addition, parents, siblings and children of people with narcolepsy with cataplexy have 40x the risk of developing the condition.

Other Possible Causes of Narcolepsy

Here are a few more possible causes:

  • Hormonal changes (including puberty or menopause)
  • Lots of stress
  • Change in sleep patterns
  • Infections, such as a fly or a streptococcal infection
  • Pandemrix (the swine flu and H1N1 vaccine)
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Narcolepsy Treatments

Since the exact cause is yet to be found, there are currently no cures or remedies for narcolepsy.

However, it is possible to treat the symptoms through lifestyle changes and medication.

These will help minimize the impact that the condition has on your life.

Lifestyle Changes for Narcolepsy

In mild cases of narcolepsy, a few simple lifestyle changes may already do the trick.

It is also very important to inform those close to you about your condition. This will help them understand better, especially if you have a cataplexy or sleep attack.

This is especially true for the work or school environment. Many people with narcolepsy are misunderstood for being lazy or rude.

Here’s a list of a few other things you can do:

  • Take short and regularly scheduled naps throughout the day
  • Create and stick to your strict sleep schedule
  • Create the perfect sleep environment which is clean, comfortable and free of any distractions
  • Exercise regularly. However, avoid doing so right before bed time
  • Avoid nicotine and caffeine
  • Don’t eat large meals before going to bed

Narcolepsy Medication

Please only consider using medication if your symptoms are more severe. Also, it is best for your healthcare provider to prescribe you which to take along with the amounts.

Of course, as it always is, please only use the minimum dosage to trigger the desired effect of the medicine.

Here is a list of possible medications you could take against narcolepsy:

  • Stimulants: they minimize excessive daytime sleepiness.
  • Sodium Oxybate: they make sure you have a higher quality sleep during the night and minimize daytime sleepiness.
  • Anti-depressants: Many antidepressants combat hallucinations, cataplexy and sleep paralysis.

Natural Remedies for Narcolepsy

Most of the medication above may come with severe side effects. This includes nausea, anxiety, headaches, and so on.

Below is a list of natural remedies for narcolepsy. They are also known to treat other sleep disorders!

  • Gotu kola
  • Country Mallow
  • Gingko Biloba
  • Naturopathy
  • St John’s Wort
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Increasing Your Sleep Quality

Here are a few tips to improve your sleep quality!

#1 Keep Your Natural Sleep-Wake Cycle

  • Try to go to sleep and get up at the same time every day (yes, including weekends!)
  • Take correct naps
  • Combat after-dinner drowsiness if it occurs way before your bed time

#2 Exercise Regularly

  • Time it correctly! Don’t exercise right before going to bed
  • The more you do, the more sleep benefits you will feel. However, even a 10-minute walk every day already improves your sleep quality!

#3 Think About What You Eat and Drink

  • Limit caffeine and nicotine
  • Try to avoid bigger meals for dinner
  • Avoid alcohol
  • Don’t drink too many fluids before bed. You might need to go to the bathroom too often otherwise!

#4 Wind Down and Relax

#5 Create the Perfect Sleep Environment

  • Your environment should be relaxing. Turn off all screens and unnecessary lights!
  • Make sure to have the best sleep equipment for your individual needs. This includes your mattress, pillow, topper, blanket, and so on.
  • Ensure to have the right sleep temperature in your room (around 65° F or 18° C)
  • Make sure your room has enough airflow and ventilation
  • Changing or adapting your sleep position can also help!
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