Narcolepsy is a sleep disorder that usually appears between 9-and-18 years of age, or early adulthood, and consists of recurring episodes of sleep during the daytime (sleep attacks), and often disrupted nocturnal sleep. It is frequently accompanied by cataplexy (loss of muscle control when laughing, crying, angry, etc.,), sleep paralysis (inability to move for a few seconds to minutes when awakening), and hypnagogic hallucinations (frightening dreamlike hallucinations when awakening or falling asleep). Rarely does a child or teenager have all of these symptoms initially or simultaneously. Not even most adults have all of these symptoms at the same time. The symptoms may come and go, and they become more severe with age.

Narcolepsy often begins by the person experiencing excessive daytime drowsiness, or falling asleep at inappropriate times (in class, at work, while talking to someone or driving a vehicle, etc.). Excessive Daytime Sleepiness (EDS) is the most prominent feature in the beginning stage of Narcolepsy, even when the child or youth is getting adequate amounts of nighttime sleep. There have been documented cases of narcolepsy in children younger than 9 years of age although it is fairly rare for young children to have Narcolepsy.

It is difficult to diagnose Narcolepsy in the beginning stages, even by sleep specialists. If there is any concern that this disorder exists, this student needs to be referred to a pediatric sleep specialist who is trained to evaluate narcolepsy. Typically, the youth must undergo an overnight sleep study with Polysomnograpy (PSG) to first rule out Obstructive Sleep Apnea Syndrome (OSAS) and other nighttime disorders that can cause excessive daytime sleepiness. Then, depending on what sleep specialists may discover in the nighttime PSG study, they may request a daytime Multiple Sleep Latency Test (MSLT). This usually involves four or five daytime naps that the student is required to take, lasting at least 20 minutes each. The length of time it takes until sleep onset and REM (Rapid Eye Movement) sleep is measured during these naps.

People with Narcolepsy usually fall asleep much quicker (within about 5 minutes) than those without Narcolepsy (12 or more minutes until sleep onset is normal), and Narcoleptic patients often achieve REM (Dream State) sleep within the first 20 minutes of sleep compared to those without Narcolepsy, who usually require 60-to-90 minutes before achieving REM (Dream State) sleep. In some sleep clinics, the student's hypocretin level is also measured, which is accomplished by doing a spinal tap to get the hypocretin level. This appears to be a more accurate or definite way to diagnose Narcolepsy, but it is not a preferred method for children because extracting this spinal fluid is a painful procedure for children and teens. Often other means are used such as Daytime Multiple Sleep Latency Test (MSLT).

The primary cause of excessive daytime sleepiness that first needs to be ruled out before testing for Narcolepsy is the student's use of good sleep hygiene. If the teen is going to bed too late at night (Delayed Sleep Phase Syndrome), then s/he will be tired during the daytime and fall asleep more often. Other more common causes of excessive daytime sleepiness than Narcolepsy are Obstructive Sleep Apnea Syndrome or Periodic Limb Movement Disorder, which are diagnosed with an overnight sleep study using Polysomnography (PSG). If it appears after an overnight sleep study that the student does not have Obstructive Sleep Apnea Syndrome (OSAS) or Periodic Limb Movement Disorder causing the excessive daytime sleepiness, then a Multiple Sleep Latency Test is usually conducted the next day to rule out Narcolepsy.

If Narcolepsy is ruled out, then other causes need to be explored. More rare causes can be Idiopathic (Central Nervous System) Hypersomnia (characterized by a familial history of frequent excessive daytime sleepiness in spite of adequate nighttime sleep and good sleep hygiene (often treated by stimulant medication) or Klein-Levin Syndrome (characterized by excessive daytime sleepiness, impulsive over-eating, and hypersexuality), etc…

Narcolepsy can become very debilitating if it is not identified and untreated. If diagnosed, it is usually managed with medications designed to decrease the sleep attacks and cataplexy. In the past, Ritalin was prescribed frequently to help control the excessive daytime sleepiness (EDS) and sleep attacks. However, today there are many new medications being prescribed such as Sodium Oxybate or Xyrem, which also reduce the amount and severity of cataplexy.

The prevalence rate of Narcolepsy in the USA is about 1 in 1,500 to 1 in 2000. However, it could be higher due to frequent misdiagnoses such as various mental health disorders.

If you have any relatives who have been diagnosed with Narcolepsy, and/or your child or adolescent has some of the symptoms mentioned above, you should click the button below to SCREEN your for Narcolepsy and other common sleep disorders.

On a positive note, Narcolepsy and other major pediatric sleep disorders can usually be improved significantly with the help of a knowledgeable sleep specialist. Treatment often results in improved behaviors, achievement, and a happier, more cooperative child or adolescent. Without proper treatment, Narcolepsy can be extremely debilitating to your child or teen’s functioning and quality of life, so you should not ignore the above-mentioned symptoms. If your child has some of the symptoms mentioned above, you can SCREEN your child / adolescent for Narcolepsy and other major sleep disorders NOW by clicking “Screen Child” below: