Narcolepsy is a diagnosis given to individuals who have both excessive daytime sleepiness and a disorder of falling readily into REM sleep. The sleepiness includes the ability, in some individuals, of falling limp during emotion-laden experiences (cataplexy) and of vivid dreams occurring just as a person starts to fall asleep (hypnagogic hallucinations). Usually narcolepsy has its onset in the teen years, but the young person struggles to stay awake in school and may be accused of being lazy or even stupid out of general ignorance regarding the condition. A brief nap may relieve the symptoms of sleepiness for many persons with narcolepsy, but the return of sleepiness in 1-2 hours is typical.
In clinically suspected cases of nacolepsy, the diagnosis is established by a multiple sleep latency test (MSLT) in which the person is challenged with 4-6 twenty minute naps spaced 2 hours apart. The occurrence of at least 2 REM onsets in the naps and an average sleep onset of 5 minutes or less in the naps establishes the diagnosis. Treatment of the narcoleptic person requires a combination of proper use of stimulant medicines and occasional naps interspersed through the day.
The sleep doctor reviews the results of a sleep study with a polysomnograph technician.
Any child or adult who has excessive daytime sleepiness even in the absence of some obvious signs of narcolepsy deserves to be evaluated in a sleep laboratory so that a proper diagnosis and appropriate treatment can be instituted. For further information you may wish to contact Dr. Scheer by e-mail.
