Narcolepsy disrupts the natural sleep and wake cycles, creating risks for physical health and mental well-being. But, with medication and healthy habits, you can manage the disorder and live a full life.

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Excessive daytime sleepiness

People with narcolepsy often experience an irresistible urge to sleep during the day. This drowsiness can interfere with work, school, and other activities. It may occur more frequently during monotonous or stressful situations.

Narcoleptics also tend to experience a sudden loss of muscle tone (cataplexy), which can range from drooping eyelids to total body collapse. This can be triggered by laughter and intense emotions, such as fear or anger.

Some people with narcolepsy fall into rapid eye movement (REM) sleep within 15 minutes of going to bed at night. This may cause them to act out their dreams, a condition known as REM sleep behavior disorder. Many people with narcolepsy have other health problems, such as depression. Talk to your doctor about getting treatment for these conditions.

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Sleep Paralysis

People with narcolepsy sometimes have episodes of sleep paralysis. This means they can't move or speak when they regain consciousness after falling asleep or waking up. Episodes usually last a few minutes. They can be triggered by emotions such as surprise or anger.

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Sleep paralysis can be frightening. It can also lead to a lack of concentration and poor performance at school, work, or other activities. Some people with narcolepsy have difficulty driving or using power tools and may be at risk of injury from falls when cataplexy occurs.

A doctor can diagnose narcolepsy by reviewing the symptoms and medical history. They can also check whether the person has an underactive thyroid gland (hypothyroidism). A specialist may refer the patient for a sleep study to monitor how they sleep, including the rapid eye movement (REM) phase.

Cataplexy

Almost all people with narcolepsy have excessive daytime sleepiness (EDS). Occasionally, strong emotions like laughter or fear can trigger a sudden loss of muscle tone called cataplexy. This can range from drooping eyelids to a complete body collapse. These episodes last a few minutes and may cause slurred speech and a lack of coordination.

Most people with narcolepsy also have disrupted nighttime sleep, periods of acting out dreams while sleeping, and periodic leg movement disorder (PLMD). They might enter rapid eye movement (REM) sleep frequently, usually within 15 minutes of falling asleep, and experience the muscle weakness or dream activity that is typical of REM sleep during wakefulness.

A healthcare provider can diagnose narcolepsy with a simple sleep-wake test, such as actigraphy. They might also check for a very early interruption of REM sleep and for certain gene mutations associated with the disease.

Memory Loss

People with narcolepsy sometimes forget what they’ve done or said during sleep episodes. This can cause problems at work or school, and raise the risk of serious accidents and injuries.

Other symptoms can be less obvious. For example, some people have cataplexy (sudden episodes of muscle weakness) that can last from a few seconds to several minutes. It’s often triggered by strong emotions, like surprise or anger.

A health professional can diagnose narcolepsy by reviewing your symptoms and medical history. Then they may ask you to track your sleep and wake patterns using a tool called actigraphy. Or they might perform a test to measure the levels of orexins in your blood, which are produced by neurons in the hypothalamus and help control the sleep-wake cycle.

Depression

It’s not uncommon for people with narcolepsy to feel depressed or sad, especially during sleep attacks. They might also experience memory lapses and find it hard to concentrate. This can be very frustrating and distressing for people with narcolepsy, and it is often difficult to cope with at work and socially.

Another sign of narcolepsy is cataplexy, which causes a sudden loss of muscle tone that can lead to weakness and body collapse. These episodes are usually triggered by intense emotions, such as surprise, anger, or fear.

Narcolepsy is a long-term condition with no cure, but medicines and lifestyle changes can help reduce symptoms. Doctors can prescribe medication to improve wakefulness, reduce the risk of sleep paralysis and prevent cataplexy. They might also recommend an overnight sleep study and a lumbar puncture (spinal tap) to measure the level of hypocretin in cerebrospinal fluid.