Medical Encyclopedia


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Sleep patterns in the young and aged
Sleep patterns in the young and aged

Alternative Names    Return to top

Daytime sleep disorder

Definition    Return to top

Narcolepsy is a sleep disorder that causes excessive sleepiness and frequent daytime sleep attacks.

Causes    Return to top

Narcolepsy is a neurological disorder, not a mental illness. The exact cause is unknown. Genes may play a role, but it is not the only factor. Anxiety, however, does not cause narcolepsy.

The disorder may be made worse by conditions that cause insomnia such as disruption of work schedules.

Symptoms    Return to top

Persons with narcolepsy have episodes of sudden daytime sleeping ("sleep attack"), usually preceded by drowsiness. It may be difficult for a young adult to stay awake during classes or work.

The sleep attacks:

Sometimes, the person may have dreamlike hallucinations before sleep or during the sleep episode. The person wakes up feeling refreshed after each brief sleep episode.

Narcolepsy may also be associated temporary and sudden muscle weakness called cataplexy, that is usually brought on by strong emotions. This may involve:

Exams and Tests    Return to top

The doctor will perform a physical exam and order blood work to rule out conditions that can cause similar symptoms. Conditions that can cause excessive sleepiness include:

Other tests may include:

Tests will also include a sleep study (polysomnogram). The Multiple Sleep Latency Test (MSLT) may be used to help diagnose narcolepsy. This test measures how long it takes you to fall asleep during a daytime nap. Patients with narcolepsy fall asleep much faster.

Treatment    Return to top

There is no known cure for narcolepsy. The goal of treatment is to control symptoms.

Lifestyle adjustments and learning to cope with the emotional and other effects of the disorder may improve functioning in work and social activities. This involves:

Prescription medications may be necessary. The stimulant drug modafinil (Provigil) is the first choice of treatment for narcolepsy. It has much less abuse potential than other stimulants. The medicine also helps maintain wakefulness. Other stimulants include dextroamphetamine (Dexedrine, DextroStat) and methylphenidate (Ritalin).

Antidepressant medications can help to reduce episodes of cataplexy, sleep paralysis, and hallucinations. Antidepressants include:

Sodium oxybate (Xyrem) is prescribed to certain patients for use at night.

If you have narcolepsy, you may have driving restrictions. Restrictions vary from state to state.

Outlook (Prognosis)    Return to top

Narcolepsy is a chronic, life-long condition. It is not a deadly illness, but it may be dangerous if episodes occur during driving, operating machinery, or similar activities. Narcolepsy can usually be controlled with treatment. Treating other underlying sleep disorders can improve symptoms of narcolepsy.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if symptoms of narcolepsy occur.

Call your health care provider if narcolepsy does not respond to treatment, or if other symptoms develop.

Prevention    Return to top

There is no known prevention for narcolepsy. Treatment may reduce the number of attacks. Avoid situations that aggravate the condition if you are prone to attacks of narcolepsy.

References    Return to top

Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet. 2007 Feb 10;369(9560):499-511.

Morgenthaler TI, Kapur VK, Brown T, Swick TJ, Alessi C, Aurora RN, et al. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep. 2007 Dec 1;30(12):1705-11.

Update Date: 9/9/2008

Updated by: Luc Jasmin, MD, PhD, Department of Neurosurgery and Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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