Narcolepsy: Symptoms, Cause And Treatment

The reality of narcolepsy is one of significant disruption to everyday life—difficulty working and tremendous strain on the person affected, their friends, and family. Keep reading to find out exactly what narcolepsy is and how to treat this chronic sleep disorder.

What is narcolepsy?

Although rare, narcolepsy^[1] is a chronic neurological condition that causes people to fall asleep or feel tired uncontrollably. The brain’s inability to control its sleep-wake cycle causes it to enter the REM phase repeatedly and without warning. As a result, a person’s quality of life is severely impacted, often preventing them from working, participating in social events, or even driving.

It’s common for most cases of narcolepsy to manifest during adolescence, with attacks of sleepiness split into two groups; type 1 and type 2 narcolepsy. The former is usually accompanied by a loss of muscle control (cataplexy), while the latter is not. Another unusual factor of narcolepsy is the potential trigger for episodes of sleepiness—emotion. Intense emotions such as laugher, happiness, anger or frustration can all provoke and exacerbate symptoms.

Diagnosing narcolepsy

In severe cases, narcolepsy is easy to identify, but it does share symptoms with several other neurological disorders. Because of this, doctors may perform additional tests or examinations. In fact, one of the only symptoms specific to narcolepsy is cataplexy, the involuntary loss of muscle strength and tone.

Two frequently used tests include polysomnogram (PSG) and multiple sleep latency test (MSLT). A PSG or sleep study monitors brain, muscle, and eye activity during sleep, while an MSLT test checks whether the person affected enters REM sleep and how often.

Unfortunately, there is no cure for narcolepsy, mainly because doctors and physicians still aren’t sure what exactly causes the condition. Encouragingly though, lifestyle changes and medication can help ease symptoms―more on these shortly.

Symptoms of narcolepsy

The most recognized symptoms of narcolepsy are sleepiness and suddenly falling asleep, but the condition can affect individuals in other ways, including:

• Cataplexy: A sudden loss of muscle strength and tone. It usually accompanies a sleep attack and can affect muscles all over the body, including the face.

• Sleep paralysis: Described as a temporary inability to move or speak, while still conscious of your surroundings, sleep paralysis can be an incredibly upsetting symptom of narcolepsy. It’s most commonly experienced as a person is falling asleep or waking up, with episodes usually lasting several seconds to a few minutes.

• Insomnia: It may seem strange to list insomnia as a symptom of narcolepsy, but it’s important to highlight that the condition is not just about falling asleep uncontrollably. Narcolepsy is a fundamental disruption to your body’s sleep-wake cycle, which for some means difficulty falling asleep at night.

• Hypnopompic hallucinations: Similar to sleep paralysis, hallucinations from narcolepsy usually occur as you’re falling asleep or waking up. The illusions are often vivid and unsettling.

• Automatic behaviours: People with narcolepsy may continue doing everyday activities, even while they experience a sleep attack. Performance is almost always impaired, with the individual unable to recall the last few seconds. Automatic behaviours usually only occur for habitual activities such as driving a car, writing or shopping for food.

Causes of narcolepsy

Perhaps the most disheartening aspect of narcolepsy is the lack of understanding regarding potential causes or triggers. Researchers have noticed that in nearly all cases of narcolepsy, an individual has deficient levels of the naturally occurring hormone hypocretin. Also known as orexin, hypocretin plays a crucial role in regulating wakefulness, feeding, arousal, and other behaviours.

While scientists know that people with narcolepsy typically have abnormally low levels of hypocretin, they don’t know what causes the deficiency to begin with. Damage to the neurons responsible for producing hypocretin is the most likely cause, but why that dysfunction occurs in some people and not others remains unclear.

Possible causes of narcolepsy include:

• Damage to the neurons responsible for hypocretin production (usually the result of major psychological stress, swine flu, or other serious infections)
• Autoimmune disorders
• Family history of narcolepsy
• Brain trauma

How to treat narcolepsy

While it isn’t possible to treat a condition with an unknown cause, there are still several steps people living with the illness can take to improve their quality of life. The effectiveness of each treatment differs according to the person’s lifestyle and narcolepsy severity, but potentially beneficial therapies include:

Stimulants and selective serotonin reuptake inhibitors (SSRIs)

Both of these aim to tackle the secondary impact of narcolepsy. The former can improve wakefulness during the day and go some ways to restore a balanced sleep-wake cycle. The latter tackles the mood-related impact of narcolepsy, as it’s common for people to develop depression or anxiety because of the condition.

Lifestyle adjustments

Many people living with narcolepsy choose to structure their day differently to help prevent the risk of accidents or injury during a sleep attack. This usually involves planning in regular naps to combat the effect of daytime tiredness, sticking to a consistent sleep schedule, avoiding caffeine after midday, and focusing on relaxing sleep routines.

Regular exercise is another recommended lifestyle because it helps address excessive weight gain. Individuals with narcolepsy frequently struggle to maintain a healthy weight, leading to further complications.

Can CBD help with narcolepsy?

Similar to many of the existing treatment methods, CBD does not address narcolepsy directly, but may have implications for particular symptoms or secondary effects. Of all narcolepsy’s symptoms, the interaction between CBD and insomnia is the most understood.

A joint case series between several notable universities highlighted the impact of CBD on sleep and anxiety^[2]. While they acknowledged that “controlled clinical studies” are still needed, their findings may prove pivotal for people living with narcolepsy and other sleep-related disorders. Given the compounds lack of toxicity and generally well-tolerated side effects^[3], it certainly makes for an attractive prospect alongside the traditional treatments options outlined above.

The drawback is CBD’s potential interaction with medication, including SSRIs and stimulants. Cannabidiol can disrupt the half-life of these medications, so you must discuss the implications of such an interaction with your doctor or physician. With their case-specific advice, it is possible to overcome the challenging nature of narcolepsy and continue doing the activities you love.

Why not explore Cibdol’s range of natural sleep supplements by visiting our dedicated sleep section. Or, to learn more about the neurochemicals involved in sleep, and why sleep is vital to physical and mental well-being, visit our CBD Encyclopedia.