Diagnosing and Treating Narcolepsy

Narcolepsy can be a scary sleep disorder – but it is treatable. Discover the most common treatment methods.

There are a number of health conditions apart from narcopelsy that can cause excessive daytime sleepiness, including sleep apnea. To determine the exact cause of your symptoms, a complete health exam and a number of tests may be performed.

  • Sleep study. A PSG, or overnight polysomnogram, may be performed in a sleep lab to check for abnormalities in your sleep cycle and to rule out other sleep disorders.
  • Multiple sleep latency test (MSLT). This is performed during the day to measure a person’s tendency to fall asleep and determine how long it takes for REM sleep to occur. Normal sleep latency periods take 10 minutes or longer, so if you have a sleep latency period of five minutes or less, narcolepsy may be to blame.

If a patient goes to the doctor and describes having a cataplectic attack, no further testing is usually needed, says David Schulman, MD, MPH, chief of pulmonary and critical care medicine at Emory University Hospital in Atlanta. “If you have cataplexy, then you definitely have narcolepsy,” says Dr. Schulman. “No other condition causes cataplexy.”

Getting the Right Treatment for Narcolepsy

There is no cure for narcolepsy, but these medications are often used to treat narcolepsy symptoms:

  • Modafinil (Provigil). This is a stimulant used during the day to promote wakefulness and alertness. “Provigil doesn’t make you feel hyped-up like other stimulants,” says Shives. “People may have a mild headache when they first start taking it, but that tends to go away after a while.”
  • Sodium oxybate (Xyrem). This strong sleep drug may be given at night to promote sound sleep, diminish daytime sleepiness, and reduce the number of cataplectic attacks. Sodium oxybate is also known as GHB, or the “date rape drug,” but is considered safe for treating narcolepsy when used in a controlled manner.
  • Antidepressants. Drugs such as tricyclic antidepressants, like imipramine (Tofranil), desipramine (Norpramin), clomipramine (Anafranil), protriptyline (Vivactil), and selective serotonin reuptake inhibitors, or SSRIs, including fluoxetine (Prozac) and sertraline (Zoloft), may also help control cataplexy.

In addition to drug treatments, Shives advises keeping a regular sleep-wake cycle. This means getting an adequate amount of sleep at night, every night. “Don’t sleep-deprive yourself,” says Shives, who also recommends avoiding alcohol and caffeine near bedtime. When possible, take several short naps (less than 30 minutes) each day.

When you have narcolepsy, you may live in fear of falling asleep at an inappropriate time and place or having a cataplectic attack — there is the potential for great embarrassment when these symptoms happen in public. Counseling and support groups can help you better cope with the condition. “Quality of life can be remarkably improved with treatment,” says Schulman. The first step is to see your doctor.

By Hedy Marks, MPH – Medically reviewed by Pat F. Bass III, MD, MPH

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