Narcolepsy

Patients with narcolepsy consistently experience unintended episodes of drowsiness or sleep throughout the day. These characteristic symptoms of narcolepsy can be scary and should prompt a visit to a sleep medicine expert: 

 

• Cataplexy (hypotonia) – A sudden loss of muscle tone, leading to a loss of voluntary muscle control and weakness 
• Vivid, frightening hallucinations at the onset of sleep or while awakening 
• Brief episodes of total paralysis (inability to move) at the beginning or end of sleep 
• Additional sleep disorders, such insomnia, restless legs syndrome and obstructive sleep apnea  

 

To diagnose insomnia, a Houston Methodist sleep specialist will talk with you about your sleep and general health history. Then, we will perform a physical examination to rule out other potential ailments and assess you for physical injuries caused by falling or jolting during an episode. 

The final step in diagnosis is to undergo two sleep study evaluations: 

 

• Polysomnogram – In this traditional sleep study, you will stay overnight in our hotel-like sleep laboratory. As you rest, a certified sleep technician will use a state-of-the-art recording system to make a video of your brain waves and monitor the electrical activity of your muscles and your eye movement, breathing rate and airflow, body position, blood pressure, blood oxygen saturation, and heart rate and rhythm. 
  
   
• Multiple sleep latency test (MSLT) – The day after the polysomnogram, we will ask you to take five short naps throughout the day, with at least two hours between them. You will be diagnosed with narcolepsy if you fall asleep within an average of eight minutes each time or fall into rapid eye movement (REM) sleep within 15 minutes during at least two of the naps. REM sleep is a deep state of sleep that occurs after an hour of sleep in people who don’t have narcolepsy. 

While there is currently no cure for narcolepsy, Houston Methodist is on the leading edge of research and the latest treatment approaches. Most patients can effectively manage narcolepsy with medication and behavior modification. 

Your doctor may recommend either an antidepressant medication to suppress REM sleep and reduce cataplexy or a stimulant to increase alertness. Modifying daily habits can enhance the effects of medication. If you have narcolepsy: 

 

• Avoid addictive substances, such as alcohol, caffeine and nicotine, which can exacerbate symptoms 
• Build short naps into the day to help retain energy 
• Exercise regularly to increase energy during the day and improve sleep at night 
• Follow a consistent sleep schedule to improve sleep 
• Replace screen time with reading or another relaxing activity before bed to help you fall and stay asleep easier 

Underlying physical or psychiatric problems, such as a breathing disorder or depression, can cause daytime sleepiness that may be misdiagnosed as narcolepsy. These conditions require specialized treatment and will not respond to typical narcolepsy therapies. 

If your current narcolepsy treatment is not providing sufficient relief, or if you have not received a proper diagnosis for daytime fatigue, our board-certified sleep medicine doctors and registered sleep technicians can find solutions and help improve your quality of life. 

Our sleep medicine providers are part of a multidisciplinary team, offering patients streamlined access to mental health, neurological and physical medicine experts. Together, we will pinpoint and treat the cause of your sleep disturbance and help you develop healthy lifestyle patterns to achieve better sleep.