Narcolepsy is a condition that affects the brain and nervous system; it makes it difficult to control waking and sleeping. People with this disorder sleep uncontrollably during the day; they can suddenly fall asleep in the middle of any activity, which can be a problem for their daily routine.

In a normal sleep circle, a person goes from the early stage of sleep to a deeper stage and then to rapid eye movements (REM) sleep. This process takes about 90 minutes, but people with narcolepsy can enter into REM sleep immediately after they close their eyes. 

There are two types of narcolepsy; type 1 usually causes cataplexy, a loss of muscle tone that leads to extreme weakness and makes it hard to control the muscles. Then there is type 2 narcolepsy, which doesn’t cause cataplexy. 

Causes

The specific cause of narcolepsy is still unknown; experts think it can be caused by multiple factors linked together. However, people with type 1 narcolepsy usually have low levels of hypocretin, also known as orexin. This chemical in the brain helps control being awake and falling asleep. 

The exact cause of the low levels of hypocretin in the brain is also unknown. Experts suggest it may be due to an autoimmune reaction that causes the immune system to destroy the cells responsible for creating hypocretin in the brain. 

It is also likely that genetics may play a role in this disorder, but the risk of this disorder being hereditary is 1% to 2%. Narcolepsy isn’t contagious, so it cannot spread from one person to another. 

Symptoms of Narcolepsy

• Excessive daytime sleepiness (EDS).
• Disrupted night-time sleep.
• Cataplexy.
• Sleep paralysis.
• Changes in REM sleep.
• Automatic behaviour, such as losing control over an activity. 
• Hallucinations.
• Insomnia.

Although everyone with this condition experiences excessive daytime sleepiness, the other symptoms may not occur simultaneously, and some people may not experience them until a few years after EDS has begun. 

Treatment

There is no permanent cure for narcolepsy type 1 or type 2. However, there are treatment options that can help reduce the symptoms and enhance the quality of life.

For some people, the symptoms will improve significantly and rarely occur, but in others, they may still experience some spontaneous symptoms, so the condition unfolds differently for different people. Here are the treatment options for narcolepsy. 

Lifestyle Changes 

These are non-medical forms of therapy that are necessary to help people with this condition live normal lives. 

• Avoid alcohol and any sedative.
• Have a good sleeping routine.
• If possible, avoid driving or talk to your doctor about safe driving.
• Eat a balanced diet.
• Exercise. 
• Join a support group. 

Medications

The drugs used for the treatment of narcolepsy include:

• Antidepressants to treat problems with REM sleep.
• Pitolisant to help you stay awake for longer periods.
• Stimulants to treat sleepiness. 
• Sodium oxybate to treat cataplexy, night-time sleep disruptions and EDS.
• Methylphenidate to reduce EDS.