Many people chalk up constant tiredness to stress, a busy lifestyle, or insufficient rest. But what if there’s more to it? If you’ve been battling persistent daytime sleepiness, it could be a sign of narcolepsy, a sleep disorder that often goes undiagnosed.
Unlike insomnia, which keeps you up at night, or sleep apnoea, which disrupts your breathing, narcolepsy makes it nearly impossible to stay awake during the day. If this sounds familiar, it might be time to consider whether narcolepsy could be the cause.
So, if you’re nodding off in meetings, while watching TV, or even while driving, narcolepsy may be affecting your sleep without you even knowing it.
Let’s take a closer look.
What Causes Narcolepsy?
The truth is narcolepsy is still a bit of a mystery, but researchers have some solid insights into what causes it.
One of the main culprits is a chemical in your brain called hypocretin (or orexin). Hypocretin helps regulate your sleep-wake cycles. When you have narcolepsy, your brain isn’t producing enough of it, which is why your body struggles to stay awake during the day. This hypocretin deficiency is believed to be caused by an autoimmune response where your immune system attacks the cells that produce this chemical.
Genetic factors are also involved, and certain triggers like infections or extreme stress may bring symptoms. While the exact cause might not always be clear, it’s important to understand that narcolepsy is a condition that impacts the brain, and it’s not something you can just “power through.”
How to Spot the Signs of Narcolepsy
Narcolepsy can manifest differently from person to person, making it difficult to diagnose. However, there are several key symptoms commonly associated with the condition that can help you determine if narcolepsy might be affecting your sleep:
- Excessive daytime sleepiness (EDS): This is the hallmark symptom of narcolepsy. People with EDS often feel an overwhelming urge to sleep during the day, regardless of how much sleep they’ve had the night before. This can lead to unintended naps and difficulties staying awake during everyday activities like work, conversations, or even driving.
- Cataplexy: This is a sudden, temporary loss of muscle control triggered by intense emotions such as laughter, surprise, or anger. The severity can range from slight muscle weakness (like your knees buckling) to full-body collapse. Unlike fainting, people experiencing cataplexy are fully aware of what’s happening but can’t move.
- Sleep paralysis: Upon waking or falling asleep, you may be unable to move or speak for a short period, typically lasting a few seconds to a few minutes. Though it can feel frightening, sleep paralysis is harmless and temporary, and it’s more common in people with narcolepsy.
- Hallucinations: These vivid, dream-like experiences occur at the boundary between sleep and wakefulness. They can be visual, auditory, or even tactile and feel incredibly real, making distinguishing between reality and dream difficult. These hallucinations typically occur as you’re falling asleep (hypnagogic) or waking up (hypnopompic).
How is Narcolepsy Diagnosed?
Narcolepsy is diagnosed through clinical evaluation and specialised sleep studies, primarily using two key tests: polysomnography (PSG) and the Multiple Sleep Latency Test (MSLT). While these terms may sound technical, the process is straightforward and essential for an accurate diagnosis.
- Polysomnography (PSG): This is an overnight sleep study conducted in a specialised sleep clinic. During the PSG, sensors are attached to various body parts to monitor brain waves, heart rate, eye movements, muscle activity, breathing patterns, and oxygen levels while you sleep. The PSG helps rule out other sleep disorders, such as sleep apnoea or restless leg syndrome, which can cause similar symptoms. It also tracks whether you’re entering REM (Rapid Eye Movement) sleep too quickly, a hallmark of narcolepsy.
- Multiple Sleep Latency Test (MSLT): The MSLT is conducted the next day after the PSG. This test measures how quickly you fall asleep during several short naps scheduled regularly throughout the day. In people with narcolepsy, sleep onset is usually rapid, and they tend to enter REM sleep within minutes—a process that normally takes about 90 minutes for most individuals. The MSLT is crucial in confirming a narcolepsy diagnosis, as it evaluates both sleep latency (how fast you fall asleep) and REM latency (how quickly you enter REM sleep).
Additionally, your doctor may take a thorough medical history, asking about your sleep habits, any daytime symptoms like excessive sleepiness or sudden muscle weakness (cataplexy), and how these affect your daily life. In some cases, a lumbar puncture may be performed to measure levels of hypocretin (also called orexin), a brain chemical that regulates wakefulness. Low levels of hypocretin are often seen in people with narcolepsy with cataplexy.
Our experienced team ensures you are supported throughout the testing process, walking you through each step and ensuring you’re comfortable. We take pride in delivering accurate results so you can move forward with a tailored treatment plan.
Treatment Options for Narcolepsy at Manse Medical
Once narcolepsy is diagnosed, the next step is developing a personalised treatment plan to help you effectively manage your symptoms. We believe a tailored approach is vital to improving your quality of life, as no two cases of narcolepsy are the same. We aim to create a plan for your specific symptoms and lifestyle needs. Here are some of the most common treatment options:
Medications
Medications play a central role in managing narcolepsy symptoms, and the type prescribed will depend on the symptoms you experience most frequently:
- Stimulants: To combat excessive daytime sleepiness (EDS), stimulant medications like dexamfetamine, modafinil or armodafinil are often recommended. These help improve wakefulness during the day without causing jitteriness or dependency.
- Sodium Oxybate: Sodium oxybate is highly effective for individuals with severe cataplexy or disrupted nighttime sleep. It reduces episodes of cataplexy and improves nighttime sleep quality, allowing for better daytime alertness but is difficult to access in Australia..
- Antidepressants: Certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), may be prescribed to help manage symptoms of cataplexy, sleep paralysis, and hypnagogic hallucinations by regulating sleep cycles and reducing muscle weakness triggered by emotions.
Each medication has potential side effects, so our team will closely monitor your progress and adjust dosages or medications as needed to ensure you achieve the best possible outcome.
Lifestyle Changes
In addition to medications, certain lifestyle adjustments can make a big difference in managing narcolepsy. Our specialists will work with you to create a structured daily routine to stabilise your sleep patterns:
- Establishing a Consistent Sleep Schedule: Going to bed and waking up at the same time every day, even on weekends, can help regulate your body’s internal clock and reduce unpredictable bouts of sleepiness.
- Planned Naps: Short, scheduled daily naps can help alleviate EDS. These naps can restore alertness and minimise the need for unintentional dozing off during important activities.
- Avoiding Stimulants Before Bedtime: Reducing caffeine or alcohol intake in the afternoon and evening can improve the quality of nighttime sleep and make it easier to feel rested the next day.
- Diet and Exercise: Regular physical activity and a balanced diet can positively impact sleep quality and energy levels, making it easier to manage symptoms during the day.
Safety Precautions
Living with narcolepsy can sometimes lead to safety concerns, especially if you experience sudden sleep attacks or cataplexy. Our team of sleep specialists emphasises the importance of safety in your daily life and provides practical strategies to prevent potentially dangerous situations:
- Driving Safety: Falling asleep at the wheel is a severe risk to individuals with narcolepsy. We’ll assess your condition and guide you on whether it’s safe to drive or if additional precautions are needed, such as avoiding long drives or adjusting your medication schedule to reduce drowsiness during driving hours.
- Workplace and Activity Modifications: Depending on the severity of your symptoms, certain activities or work tasks may need to be modified. We’ll work with you to find ways to remain productive and safe, whether taking regular breaks, scheduling naps, or adjusting your work environment.
By combining medical management with lifestyle adjustments, we aim to help you regain control over your sleep and improve your daily functioning.
Why We Are Narcolepsy-Management Experts
Dealing with narcolepsy can feel overwhelming, but with the proper support, you can manage your symptoms and live a fulfilling life. We offer more than just treatments. We’re committed to supporting you throughout your journey— from diagnosis to long-term management.
Our Narcolepsy Connect Program is specially designed to provide continuous support for those managing narcolepsy. Through this program, you’ll receive access to a range of benefits, including expert-led education, tailored management plans, and a network of others with narcolepsy to foster shared experiences and support. The Narcolepsy Connect Program focuses on ensuring that each patient feels informed, empowered, and never alone in their journey.
Narcolepsy affects more than just sleep. It affects your work, relationships, and overall well-being. That’s why we offer comprehensive, personalised care that includes regular follow-ups, adjustments to your treatment plan as needed, and ongoing education to help you understand your condition better. If you’re tired of feeling tired, it’s time to take the next step.
Living with narcolepsy doesn’t have to mean feeling exhausted or out of control. Understanding the condition, properly diagnosing, and following a treatment plan can make a difference. If any of these symptoms sound familiar, book an appointment today. We’re here to help you regain control of your sleep and life.
If you require more information, please phone us at 1300-626-730 or email: admin@mansemedical.com.au
