What is Narcolepsy?
Narcolepsy is a chronic neurological disorder that affects the brain’s ability to control wake-sleep cycles. It is the second-leading cause of excessive daytime sleepiness after obstructive sleep apnea. Narcolepsy is thought to affect roughly 1 in 2,000 people, with symptoms often first appearing in childhood or adolescence. People with narcolepsy may feel rested after waking, but then feel extremely tired throughout the day. They may involuntarily fall asleep during normal activities.
People with narcolepsy suffer from interrupted and uneven sleep patterns, typically entering the REM stage – where dreaming happens – almost immediately or sometimes even when they are still awake. This condition can have a debilitating impact on a person’s life but is treatable. The sleep specialists at UTHealth Neurosciences will work quickly and diligently to diagnose the condition and provide quality treatment.
Causes of Narcolepsy
Narcolepsy is typically caused by a deficiency of hypocretin, a brain chemical that promotes wakefulness and regulates REM sleep. The immune system attacks the neurons in the hypothalamus that produce hypocretin. When these neurons diminish, changes between sleep and wakefulness can happen spontaneously. This autoimmune response might be triggered by an inherited genetic condition, hormone changes, stress, or certain infections.
Researchers have discovered that a specific gene variation involving the human leukocyte antigen seems to make people more susceptible to developing narcolepsy. Scientists have also discovered that individuals with narcolepsy can have high levels of anti-streptolysin O antibodies, which can follow an immune response to strep throat or other bacterial infections.
Secondary narcolepsy – or narcolepsy likely caused by another condition or injury – can develop after encephalitis, a head injury, brain tumor, or Multiple Sclerosis.
Signs of Narcolepsy
Narcolepsy can interfere with psychological, social, and cognitive functions. It can have a disabling impact on patients’ academic, work, and social lives. People with narcolepsy are also prone to accidents because of their excessive sleepiness and because they may fall asleep at dangerous times, such as while driving.
The most common symptoms are excessive daytime sleepiness, sleep-related hallucinations, sleep paralysis and cataplexy, which is a sudden loss of muscle tone and voluntary muscle control.
It is a lifelong condition, but it does not worsen with age.
Males and females suffer equally from narcolepsy. Symptoms often start between the ages of 7 and 25, but the condition is sometimes misdiagnosed as a psychiatric or emotional problem. Symptoms can also be mistaken as laziness or boredom. Many patients remain undiagnosed or incorrectly diagnosed for more than a decade, according to recent research.
Your doctor will diagnose narcolepsy by taking a medical history, performing a clinical examination, and conducting a sleep analysis. Conditions such as sleep apnea, epilepsy, and depression should be ruled out first. You might be asked to keep a sleep journal and to complete a sleepiness scale questionnaire to assess how likely you are to fall asleep during different activities. A nocturnal polysomnogram, or sleep study, may be conducted overnight to record brain activity, breathing, and movement. A multiple sleep latency test may be performed during the day to see how quickly you fall asleep and enter REM sleep.
Narcolepsy has a significant effect on sleep cycles and sleep quality. While there is no cure, symptoms can be treated with medication and lifestyle changes. Your team at UTHealth Neurosciences will attempt to find the best combination to help ensure a high quality of life. A central nervous system stimulant might be prescribed first to reduce daytime drowsiness and improve alertness. If this is not effective, an amphetamine-like stimulant might be prescribed. An antidepressant or sodium oxybate might also be considered to help control cataplexy and other symptoms.
Patients might be encouraged to take short naps, maintain regular sleep schedules, and avoid caffeine in the evenings. Daily exercise and smaller meals before bedtime might also improve symptoms.
What You Can Expect at UTHealth Neurosciences
At UTHealth Neurosciences, a team of neurologists and other highly trained specialists will develop a personalized treatment plan for you. Throughout the treatment process, our team works closely with the doctor who referred you to ensure a smooth transition back to your regular care.
At UTHealth Neurosciences, we offer patients access to specialized neurological care at clinics across the greater Houston area. To ask us a question, schedule an appointment, or learn more about us, please click below to send us a message. In the event of an emergency, call 911 or go to the nearest Emergency Room.