Narcolepsy is a rare, long-term brain condition that can stop a person choosing when to sleep and when to stay awake. It is neurological, not psychiatric. About 30,000 people in the UK have it, with symptoms often starting in the teens.
Key points
- Narcolepsy is a long-term neurological condition, not a mental health condition. The brain loses part of its control over sleep and wakefulness.
- About 30,000 people in the UK have it. Symptoms often start in the teens, diagnosis usually between 20 and 40.
- The main symptoms are daytime sleepiness, cataplexy, sleep paralysis, hallucinations around sleep and broken night-time sleep.
- Cataplexy is a sudden loss of muscle control triggered by strong emotion, usually laughter, with the person fully conscious.
- There is no cure, but naps, routine and medication reduce symptoms. Anyone diagnosed must tell the DVLA.
Symptoms
- Excessive daytime sleepiness: an irresistible urge to sleep at inappropriate times, sleep attacks with little warning.
- Cataplexy: sudden, temporary loss of muscle control set off by strong emotion, from a slight facial weakening to a full collapse, while fully conscious.
- Sleep paralysis and vivid hallucinations while falling asleep or waking; repeated waking and vivid dreams at night.
Causes and risk factors
- Most strongly linked to a shortage of the brain chemical hypocretin (orexin), thought to be autoimmune.
- Inherited genetic factors, hormonal changes, major psychological stress; a smaller group of cases follow brain damage.
Treatment
- No cure; frequent, brief naps spaced through the day and a strict bedtime routine.
- Medication to stay awake during the day: modafinil, pitolisant and solriamfetol; sodium oxybate for cataplexy and night-time sleep.
- Anyone diagnosed must not drive and must notify the DVLA; a licence may be issued once symptoms are controlled for at least three months.
When to speak to a professional
- You fall asleep during the day despite sleeping enough at night, or sleepiness affects work, study or relationships.
- You have episodes of sudden muscle weakness set off by laughter, surprise or anger.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.