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Narcolepsy is a chronic sleep disorder that causes excessive, overwhelming daytime sleepiness.
What is going on in the body?
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A person with narcolepsy has a lifelong sleep disorder. The central nervous system tells the body when to sleep and when to wake. In a person with narcolepsy, these messages are confused. The messages to sleep and wake happen at the wrong times. The body falls asleep when the person wants to be awake. The body can also be awake when the person wants to be sleeping.
What are the causes and risks of the condition?
A recent study has shown that individuals with narcolepsy are missing cells from the hypothalamus that secrete a hormone called hypocretin, or orexin. On autopsy, the brains of people with narcolepsy showed clear evidence that the cells had been destroyed, perhaps by an autoimmune disorder or a toxin. An autoimmune disorder is one in which the person's body attacks its own tissues, for unknown reasons.
Since narcolepsy has been shown to run in families, there may be a genetic component to the condition. About 1 in 2,000 people has narcolepsy, and most of these have their first symptoms between the ages of 15 and 30.
What are the treatments for the condition?
There are a number of treatments for narcolepsy that help manage the symptoms.
Excessive daytime sleepiness may be treated with medicines that stimulate the central nervous system. These stimulants include:
- dextroamphetamine sulfate, or Dexedrine
- methylphenidate HCl, or Ritalin
- modafinil, or Provigil
Tricyclic antidepressants are used to treat muscle weakness and other symptoms. These medicines can reduce symptoms but usually will not alleviate them entirely. Amitriptyline and nortriptyline are common antidepressants.
It also helps if the person makes lifestyle changes. These can include:
- avoiding caffeinated foods and beverages in the evening
- creating a sleep schedule, with set times to go to bed, wake in the morning, and take naps
- exercising regularly, at least 3 hours before bed
- joining support groups
- managing stress
- taking 10-minute naps one to four times a day
What are the side effects of the treatments?
Side effects of central nervous system stimulants include:
- addiction to the medicine
- arrhythmia, or irregular heartbeat
- headache
- insomnia
- nervousness and irritability
- mood changes
Antidepressants can cause drowsiness, erectile dysfunction, and low blood pressure.
What happens after treatment for the condition?
Treatment of narcolepsy is lifelong.
How is the condition monitored?
The person with narcolepsy will have regular visits with the healthcare provider. Any new or worsening symptoms should be reported to the provider.
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