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Narcolepsy 

Introduction
Narcolepsy is a neurological sleep disorder that consists of sudden unexpected episodes of daytime sleepiness.  The episodes typically last about 15 minutes, and a person may have several episodes at any time or place during the day.  Uncontrolled narcolepsy is dangerous because the episodes of sleepiness may come on quickly, increasing the risk of accidents and injury.  Fortunately, the symptoms of narcolepsy may be managed with lifestyle changes and prescription medication.

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Anatomy
Sleep is vital for life, just like eating and breathing.  Sleep allows your body to rest.  It is believed that during sleep your brain performs important functions, such as storing memory and processing brain chemicals. 
 
In a way, your body goes on “auto-pilot” while you sleep.  Your brain regulates automatic functions for you, such as breathing, heart rate, and blood pressure.  The average adult needs about eight hours of healthy sleep.  Although sleep is a complex process that is not fully understood, it is known that a good night’s sleep is important for optimal health and functioning.

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Causes
The exact cause of narcolepsy is unknown.  Researchers suspect that there may be a genetic component.  They also suspect that it may be caused by a shortage in the brain cells that regulate the transitions between sleep and wakefulness and wakefulness and sleep. 

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Symptoms
Symptoms of narcolepsy occur gradually and begin to appear in adolescence and young adulthood.  The first symptom to appear is usually excessive daytime drowsiness.  Other symptoms may develop over periods of months or years.

Eventually, excessive daytime drowsiness leads to uncontrollable daytime sleeping.  Sleep episodes commonly last about 15 minutes.  You may experience several such episodes each day.  You may feel quite refreshed when you wake up, but may experience another episode shortly thereafter. 

You may fall asleep at unexpected times, such as during class, work, or while driving.  The episodes of unexpected daytime sleeping most frequently occur after eating meals and during periods of physical inactivity or low mental stimulation.  Uncontrolled narcolepsy increases the risk for injury and accidents.

Some people with narcolepsy experience a loss of muscle tone, generalize weakness, or temporary paralysis during sleep and wake transitions.  Some people experience hallucinations, seeing or hearing things that are not really there especially right before falling asleep or immediately upon awakening.  Uncontrolled narcolepsy may interfere with your job, school, relationships, and activities.

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Diagnosis
You should contact your doctor if you have excessive daytime sleepiness or suspect that you have narcolepsy.  Your doctor will carefully review your medical history and may conduct evaluations to rule out other conditions with similar symptoms.  Blood tests may be used to identify if you have narcolepsy-related genes. 

You may be referred to other specialists, such as a neurologist, psychiatrist, or sleep medicine doctor.  A clinical sleep study may be conducted to learn more about how your body functions while you sleep.  A Multiple Sleep Latency Test (MSLT) is helpful for confirming the diagnosis of narcolepsy.  The test evaluates how long it takes a person to fall asleep for daytime naps and whether Rapid Eye Movement (REM) sleep occurs during the naps.  The MSLT is a measure of daytime sleepiness. 

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Treatment
Narcolepsy is a lifelong condition.  Although there is no cure for narcolepsy, the condition can be managed with lifestyle changes and prescription medication.  It can be helpful to schedule naps during the day and avoid eating heavy meals.  Treating other sleep related disorders appears to improve narcolepsy symptoms. 

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Prevention
The cause of narcolepsy is unknown, and there is no clear way of preventing its onset.  People with narcolepsy should follow their doctor’s instructions carefully and take precaution to reduce the chance of accidents.  It can be helpful to have scheduled nap times after meals or periodically throughout the day.

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Am I at Risk
Because the cause of narcolepsy is unknown, the risk factors are not well understood.  It is known that narcolepsy affects both men and women equally.  The first symptom is usually excessive daytime drowsiness.  You should talk to your doctor about any concerns that you have.  The doctor may ask if other family members are affected.

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Complications
Ask your doctor about safety precautions specific to you.  Operating machinery or driving is dangerous during unexpected sleep episodes.  Some states have driving restrictions for people with narcolepsy, so you should check with your doctor or state department of motor vehicles.

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Advancements
Patients with narcolepsy have been shown to be overweight, often despite eating less than people without narcolepsy.  The reasons are unclear, but may be due to a decreased ability of their body to burn calories, as well as a change in their eating behavior.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.