Narcolepsy: Nothing to Snooze About

Contributed by: Jenny Hu, Pharm.D. Candidate

KU School of Pharmacy

Text Box: Do you often feel excessively sleepy during the day even though you’ve had a good night’s sleep? Do you frequently fall asleep when you aren’t trying to, such as while driving, working, or talking to someone? If so, you may have narcolepsy. Narcolepsy is a serious medical disorder that affects more than 1 in 2,000 people in the U.S. It is the second cause of excessive daytime sleepiness diagnosed by sleep centers after obstructive sleep apnea (loss of breath during sleep). Narcolepsy is a disabling illness, affecting as many as 200,000 Americans, but fewer than 50,000 are diagnosed. Thus many people are left untreated. In many cases, a diagnosis is not made until 10-15 years after the symptoms start. This often occurs because most people do not think that sleepiness is a sign of a disease. It may also be mistaken for depression, epilepsy, or a side effect of medications. However, narcolepsy can be devastating because it can cause serious disruptions in a person’s social, personal, and professional lives as well as accidents. What is narcolepsy? Narcolepsy is a sleep disorder that causes excessive daytime sleepiness. People with narcolepsy will typically have uncontrollable episodes of falling asleep during the day, for periods of a few seconds to a few minutes, often at inappropriate times and places. Three other symptoms are also associated with narcolepsy:

Text Box: Cataplexy: sudden loss of muscle control, ranging from slight weakness (limping knees or neck, sagging facial muscles) to complete body collapse. These episodes can be triggered by emotions such as laughter, anger, or fear. Hypnogogic and Hypnopompic hallucinations: hallucinations while falling asleep or waking. Sleep paralysis: paralysis while falling asleep or waking. It may last from a few seconds to minutes. These symptoms can occur in people who do not have narcolepsy, but few people with narcolepsy experience all four symptoms. What causes it? Narcolepsy has no known cause, but it may be associated with genetics, REM (rapid eye movement) sleep, and blood pressure issues. Who gets it? Narcolepsy typically begins in men and women in their teens or early twenties. However, it can occur at any age. How is it diagnosed? Diagnosis is easy when all of the symptoms are present. However, it is more difficult if the sleep attacks are isolated and cataplexy is mild. A polysomnogram (study of brain waves during sleep) and a multiple sleep latency test (observes the time taken to reach various stages of sleep) can be done at a sleep disorders clinic to help diagnose narcolepsy. How is it treated? There is no cure for narcolepsy, but

Text Box: therapy includes medications for the symptoms and proper sleep hygiene. The main treatment for excessive daytime sleepiness is with stimulants such as Provigil® or Ritalin®. For cataplexy, antidepressants such as Prozac® or Tofranil® are used. In addition to drug therapy, it is important to schedule short naps (10 to 15 minutes) two to three times per day to help control the excessive daytime sleepiness and to get proper nighttime sleep. Narcolepsy is a serious, life-long condition that can have a negative psychosocial impact on a person’s life. It is important that individuals with narcolepsy as well as their friends, families, and employers learn to cope with the symptoms so that these individuals can still lead productive lives. For more information, visit: www.nhlbi.nih.gov/health/public/sleep/narcolep.htm or talk with your physician or pharmacist.