What is narcolepsy?

Narcolepsy is a condition of excessive sleepiness that may considerably impact all aspects of a child’s life including social and academic functioning. Children with narcolepsy experience the following:

  • Constant excessive daytime sleepiness
  • Ongoing struggles to stay awake
  • Falling asleep at unusual times and locations that may be unexpectedly sudden in the form of sleep attacks

What causes narcolepsy?

The exact cause of this disorder is still not known. Narcolepsy is thought to be related to a disruption in an area of the brain that controls sleep and wakefulness. In many cases, it is thought to be due to a loss of a particular chemical in the brain called hypocretin or orexin.Narcolepsy affects an equal number of boys and girls. Initial symptoms are usually not reported until individuals are between the ages of 15 and 25 but they certainly have been seen in younger children. Sometimes narcolepsy is seen in more than one family member but in most cases is not inherited. Some viral infections have been implicated in precipitating this disorder in susceptible individuals.

What are the signs and symptoms of narcolepsy?

Symptoms of narcolepsy can develop over several years or can appear together all at once. The four most common symptoms/signs of narcolepsy are:

  • Excessive daytime sleepiness: This is usually the first sign of narcolepsy. Individuals say they feel tired all the time. They can fall asleep at unusual times, such as while driving, in the middle of a conversation, or while eating.
  • Cataplexy: Cataplexy is a sudden, brief loss of muscle control triggered by stress or a strong emotion, such as laughter, anger, anxiety, or surprise. Cataplexy may be mild--like a brief feeling of weakness in the knees, or more significant such as a complete collapse to the ground from inability to maintain posture. Breathing is not affected but a sense of choking may be reported. Injury from falls is rare because the paralysis comes on over a few seconds. Cataplexy is sometimes the first symptom of narcolepsy but more often develops after months to years of having narcolepsy. It may not be seen in all cases of narcolepsy.
  • Sleep paralysis: Sleep paralysis is a brief loss of muscle control either when falling asleep or waking up. It is a feeling of being unable to move or speak, even though the person is totally aware of his or her surroundings. Being touched by another person usually causes the paralysis to disappear.
  • Hypnagogic hallucinations: These are vivid, dream-like/nightmare events that are difficult to distinguish from reality. They occur just prior to falling asleep or just after awakening. The "dreams" often involve images or sounds of strange animals or prowlers. The content is generally scary. These many times come in combination with the sleep paralysis episodes and are a part of the dream (REM) intrusion into wakefulness that occurs with narcolepsy.

Other symptoms of narcolepsy can include:

  • Disturbed sleep through the night: Difficulty sleeping through the night with frequent awakenings. This is in contrast to excessive sleepiness in the daytime.
  • Automatic behaviors: Continuing to perform routine tasks without any awareness or later memory of ever doing them (examples: writing a letter, doing homework, cooking, cleaning, driving)

Other symptoms reported by children and adolescents with narcolepsy include memory loss, lack of concentration, low motivation, sluggishness, difficulty keeping up with friends and with schoolwork. Substance abuse and depression may sometimes occur.

Last reviewed by a Cleveland Clinic medical professional on 06/25/2013.

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