How Narcolepsy Impacts Your Sleep

What Is Narcolepsy?

Narcolepsy is a sleep disorder that causes disruptions in your sleep-wake cycle. This can cause you to experience a symptom known as excessive daytime sleepiness, or EDS. EDS happens because your brain has trouble maintaining waking and sleep states. It’s common for an individual with narcolepsy to accidentally nod off during the day.

Narcolepsy can also cause irregular REM sleep patterns. In most people, sleep stages occur sequentially. First, you’re awake, then you enter light sleep, deep sleep, and finally REM. For those with narcolepsy, REM sleep isn’t always the final stage, and it can occur even before the light and deep sleep stages. These abnormal sleep patterns can prevent those with narcolepsy from getting the benefits of full sleep cycles.

How It Relates to Sleep

Narcolepsy is a sleep disorder. The primary symptoms and issues it causes are sleep-related.

What Are the Causes?

Narcolepsy is a sleep disorder that is not yet fully explained by science. There are two types of narcolepsy, Narcolepsy type 1 (NT1) and Narcolepsy type 2 (NT2). We currently understand more about type 1 and what causes it. Let’s take a look at both types and the current understanding we have for what causes them.

• NT1: NT1 occurs when people lose 90% or more of their hypocretin-making neurons. These neurons help regulate the sleeping and waking states. It’s believed that a certain genetic marker gives individuals a propensity to experience this neuron loss. Theories also posit that external triggers may cause an immune response that attacks these neurons, especially in those who have the aforementioned genetic marker. Some medical conditions, such as head trauma, can also bring on narcolepsy in rare cases. With that being said, most cases don’t have a clear cause, and while many of these theories are accepted, they’re not definitively proven to be true.
• NT2: Less is known about NT2, especially since those with NT2 don’t typically have a neuron deficiency. NT2 can sometimes be brought on by medical conditions, but as with NT1, the direct cause of this type of narcolepsy is often unclear.
  

What Are the Symptoms?

Narcolepsy is a fairly rare sleep disorder with several distinctive symptoms. You may have narcolepsy if you’re experiencing the following issues.

• Excessive daytime sleepiness: Individuals with narcolepsy will feel extremely tired or sleepy throughout the day. They may fall asleep suddenly during normal activities. This can happen no matter where they are or what they’re doing. When this happens, the individual can fall asleep for a of couple minutes or they may sleep as long as half an hour. They typically will wake up feeling better, but the sleepiness will come back.
• Lack of focus or concentration: When you’re extremely tired, it can be more difficult to focus and stay alert. You may find it more difficult to complete your normal tasks, and you may have slowed thinking and reduced memory retention.
• Cataplexy: Cataplexy causes you to lose tone and control of your muscles. When cataplexy occurs, most of your muscles will suddenly weaken. This can be brought on by intense emotions such as laughter, surprise, anger, excitement, or fear. Depending on the individual, cataplexy may be a frequent occurrence or it may just happen once or twice a year. Some individuals with narcolepsy may not experience it at all.
• Sleep paralysis: Sleep paralysis can happen when you’re falling asleep or when you’re waking up. These episodes cause your muscles to be temporarily immobile, making it so you’re unable to move. This feeling typically won’t last much longer than a few seconds or minutes. This symptom isn’t unique to narcolepsy, so if you experience sleep paralysis you may not have this sleep disorder.
• Hallucinations: Hypnagogic and hypnopompic hallucinations can happen as you’re falling asleep or waking, respectively. These hallucinations can be a feeling or they can be especially vivid, as they’re essentially a form of dreaming.
• REM sleep issues: REM is typically your final stage of sleep, but those with narcolepsy can experience REM sleep within minutes of falling asleep. For most people, true REM sleep won’t occur until 60 to 90 minutes into the sleep cycle.
  

Diagnosis

Diagnosis of narcolepsy can be a fairly extensive process. It’s a rare condition, so doctors won’t want to mistakenly attribute symptoms to narcolepsy if it could be something else.

It’s best to seek out a specialist when diagnosing narcolepsy, as this will give you the best chance of making sure that you're diagnosed correctly. Your doctor will ask you about your symptoms and your medical history. They’ll ask you about your sleep habits, and they may also consult anyone you live with to learn more about how your symptoms manifest.

Various tests will likely be conducted. These tests include the Epworth Sleepiness Scale and a polysomnography. The Epworth Sleepiness Scale is subjective and is communicated by the patient. A polysomnography test is more involved and monitors brain and body activity. This test is a type of sleep study and may require overnight monitoring. A multiple sleep latency test can also be conducted to monitor symptoms of sleepiness. This test asks the individual to fall asleep at five different times. Patients with narcolepsy are often able to fall asleep easily at these requests and quickly enter REM, which can be detected by the polysomnography sensors.

In some cases, a cerebrospinal fluid test may be conducted. This test looks at your hypocretin neuron levels and requires a spinal tap or lumbar puncture. This test can help determine the type of narcolepsy you have as well.

For a true narcolepsy diagnosis, excessive daytime sleepiness must be persistent for at least three months. The doctor will then attempt to determine if you have NT1 or NT2. Those with low hypocretin levels or symptoms of cataplexy along with consistent test results from the multiple sleep latency test may be diagnosed with NT1. NT2 is diagnosed if a patient meets similar criteria but they don’t have cataplexy or low hypocretin levels.

Treatment

There is no cure for narcolepsy as of now, but treatment can make life safer for patients while also reducing their symptoms and adding to their quality of life. 

Regardless of what type of narcolepsy you have, treatments are going to be fairly similar. There are lifestyle changes and medications that may be effective at providing symptom relief and enhancing overall quality of life. NT1 patients may take medications for cataplexy, whereas this is unnecessary for NT2 patients.

Talk to your doctor about which treatment options will be the best for you. All medications should be prescribed by your doctor and progress should be monitored by them as well. With that being said, there are some common treatments for people with NT1 and NT2.

Lifestyle Changes:

Lifestyle changes don’t require medication and are generally recommended to anyone suffering from narcolepsy. These modifications may include:

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• Regulating naps: Naps can alleviate excessive daytime sleepiness in individuals with narcolepsy, so planning for nap times can help make the days easier, and falling asleep randomly may happen less frequently. Limiting naps to 10 to 20 minutes will cause less disruption to the day and give you a boost of energy.
• Working on sleep hygiene: Your sleep hygiene involves creating a good sleep environment and forming good sleep habits. Having good sleep hygiene will ensure you’re getting the best night’s sleep possible.
• Making driving plans: Talk to your doctor about ways you can drive safely. It may help to take a brief nap before driving or to have someone else drive on long trips. Always pull over somewhere safe and take a nap if you’re feeling sleepiness coming on.
• Finding support: Though narcolepsy is rare, there are still plenty of people who deal with the condition. A support group can help you talk about your condition and find new ways to deal with symptoms.
• Avoiding alcohol: Alcohol can make you sleepy, which can cause your symptoms to worsen.
• Exercising: Exercise is good for waking up the body and mind and helping you get a restful sleep at night.

Medications:

Medications should only be prescribed by your doctor. Some medications may have side effects, so make sure to talk to your physician about the risk factors. Not all medications will work for you, and you may have to try different medications to find one that relieves symptoms while also avoiding side effects. 

Medications that your doctor may prescribe include:

• Methylphenidate
• Sodium oxybate
• Modafinil 
• Armodafinil
• Solriamfetol
• Pitolisant
  

How to Manage Your Sleep Disorder

When you have a sleep disorder, it helps you have good sleep hygiene. 

Here are some things you can try to help manage your sleep disorder:

• Stick to a sleep schedule: It’s a good idea to go to bed at the same time every night and wake up at the same time every morning. Make sure to allow at least 6 to 9 hours of sleep. Also, make sure to wake up at the same time, even on weekends and days off.
• Create an optimal sleep environment: Create a sleep environment that is dark, cool, and free of noise, make sure you have comfortable bedding that you enjoy.
• Try a sleep routine: Every night before bed, go through a sleep routine to get ready. Do something relaxing like taking a warm bath or listening to pleasant music.
• Try relaxation techniques: Relaxation techniques like meditation, breathing exercises, and light stretching can get your mind and body ready for bed.

If you want to form good sleep habits, you don’t have to do it alone. Sleep Reset can help!

Take Our Sleep Assessment Today

If you’re wanting to improve your sleep hygiene to reduce your narcolepsy symptoms, Sleep Reset is here to help. Sleep Reset is a science-backed sleep program that combines sleep coaching and proven sleep methods to help you form lasting and sustainable sleep habits. With Sleep Reset, you can wake up feeling rested and sleep through the night without using pills or supplements, which means no more grogginess and no more side effects.

When you choose Sleep Reset, you’ll get your own personalized sleep program tailored to your specific sleep concerns, along with a dedicated sleep coach. You also get sleep tracking, access to our app, and much more. We give you all the tools and help you need to get your sleep on the right track

Try our sleep assessment today to see if Sleep Reset is right for you!