Narcolepsy: Symptoms and Treatment Options

Narcolepsy: Symptoms and Treatment Options

Learn more about this sleep disorder that affects nearly 3 million people worldwide.

Narcolepsy is a sleep disorder that is believed to affect around 1 in every 2,000 people in the US. Unfortunately, it’s believed that only sleep-apneaabout 25 percent of people with this condition have actually been diagnosed and properly treated. From the office of our Portland and Astoria sleep medicine physicians, Dr. Radhika Breaden, and Dr. Jennifer Kim, here’s what you should know about this sleep disorder.

 What are the symptoms of narcolepsy?

The most obvious symptom of narcolepsy is excessive daytime sleepiness. Those with narcolepsy will experience daytime drowsiness even after getting adequate total sleep time on a regular basis. 

Unlike stereotypical portrayals of narcolepsy in the movies and on the internet, patients with narcolepsy do not typically fall asleep while talking or suddenly slump in the middle of an activity unless their narcolepsy is severe, which is very rare. Instead, most patients with narcolepsy live with their excessive daytime sleepiness during the day and try to control it with caffeine and brief naps whenever they can. However, despite these measures, the sleepiness affects their daily life and function. 

Other symptoms of narcolepsy can include sleep paralysis (waking up during the night with the body feeling paralyzed), hypnagogic or hypnopompic hallucinations (seeing visions or hearing things that are not there as you are falling asleep or waking up) although these symptoms may also be noted with other sleep conditions including sleep deprivation and obstructive sleep apnea. 

Some patients may also have cataplexy. The term cataplexy describes the loss of muscle control in the head, neck or shoulders or buckling of the knees during a time of intense emotion, such as laughter or surprise. Not all patients with narcolepsy have cataplexy. However, the presence of cataplexy can suggest that narcolepsy is present. 

 When should I see a sleep medicine specialist for consultation?

If you are dealing with the above symptoms and suspect that narcolepsy may be present, it’s important that you turn to our sleep specialists in Portland and Astoria, OR, to find out what’s going on.

 How is narcolepsy diagnosed?

In order to be diagnosed with narcolepsy, our sleep doctors will need to perform certain tests. After a careful history, we may recommend a combination sleep study called a Polysomnogram with Multiple Sleep Latency Test (PSG with MSLT).  During a sleep study, we will apply electrodes to the body to record everything from breathing patterns and movement to brain activity while you sleep. If the overnight polysomnogram does not show a clear explanation for the excessive daytime sleepiness, we proceed with the daytime napping test (MSLT) the next day. During the MSLT, a patient will attempt to nap every 90-120 minutes. By observing how rapidly a patient falls asleep and what stages of sleep are noted, Dr. Kim or Dr. Breaden will then determine whether narcolepsy is likely to be present. 

The preparation for a PSG with MSLT follows a standardized protocol which includes adequate total sleep time for the weeks prior to testing, the absence or complete treatment of other sleep disorders such as obstructive sleep apnea, the elimination of medications which may affect testing as well as the elimination of caffeine in the two weeks prior to testing. 

How is narcolepsy treated?

Your treatment plan will often include medication and lifestyle modifications to help manage your symptoms and help you get more restorative sleep. Dr. Kim and Dr. Breaden will work with you to find the right medication and treatment options to alleviate your symptoms. 

You may be prescribed medication to control sleepiness and REM sleep intrusion (sleep/wake cycle). In addition to many traditional wake promoting agents, there are several newer medications that may be helpful in promoting more restorative sleep. 

Next steps:

If you, a friend or a family member is displaying symptoms of narcolepsy or any other sleep disorder, a consultation with our sleep medicine team may help to determine the next steps in evaluation and treatment. Call Pacific Sleep Program in Portland at (503) 228-4414 or in Astoria at (503) 325-3126. 

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8:00 am-4:30 pm


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