Narcolepsy
Narcolepsy is a sleep disorder that is characterized by excessive sleepiness, “sleep attacks”, dream-like hallucinations, and in some cases sudden muscle weakness. This may happen while eating, walking or even while driving.

People with narcolepsy often experience:

• Sleep Paralysis. Unable to move for a few seconds or minutes as you are falling asleep or waking up.
• Hypnagogic hallucinations. Seeing things that are not there. You may have the feeling that there is someone in the room with you as you are falling asleep.
• Cataplexy. Leg, arm, hand or face muscles may suddenly become weak. This is frequently caused by strong emotions, anger, laughter or surprise.
• Sleep attacks. Uncontrollable episodes of falling asleep.
• Disturbed night time sleep. You wake up frequently and have trouble falling back asleep.
• Memory problems. You may have trouble remembering things that people tell you due to your not being fully awake when they are talking to you.

If you are diagnosed with narcolepsy with cataplexy, your physician will use a  different kind of drug to treat your muscle weakness.
Some people with narcolepsy find that taking planned naps help minimize the sleep attacks.

Since narcolepsy is not a common sleep problem, most primary care physicians do not see many patients who have it. A sleep specialist has specific training and experience in the diagnosis and treatment of narcolepsy, and the skill to best diagnose and manage your care. 

The frequency of narcolepsy is about one out of every 2,000 people. There does seem to be a genetic link to the disorder. It affects the same number of men as women, and it usually starts between the ages of 12 and 20. There are more people in Japan who have it, and fewer people in Israel have it. If you are unable to move when you first fall sleep or wake up, there is a high likelihood you have narcolepsy.  

It is important to know if there is something else that is causing your sleep problems. They may be a result of:

• Another sleep disorder
• A medical condition
• Medication use
• A mental health disorder
• Substance abuse

If your physician suspects that you have narcolepsy, you will need to have two sleep studies for a definite diagnosis.

1. An overnight sleep study called a Polysomnogram. This test records your sleep patterns over a full night to exclude other sleep disorders that may explain your sleep complaints.

2. The following morning you will have an MSLT, which stands for Multiple Sleep Latency Test.  During this test, you will be given 5 nap “opportunities” lasting 20 minutes each,  2 hours apart. The first nap “opportunity” begins 2 hours after you woke up from the night time test.  If you fall asleep within 5 minutes on average you are  considered to be “pathologically sleepy”. If you enter Rapid Eye Movement (REM) sleep 2 or more times over the course of the naps, and have most or all of the previously mentioned symptoms, a diagnosis of  narcolepsy will most likely be made.

You may be asked by your physician to take a test to screen you for drugs before you have the MSLT since there are a number of drugs that can affect the results of the sleep testing.

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