How Narcolepsy is Diagnosed
The most common and sometimes the only symptom of narcolepsy is excessive daytime sleepiness. Because excessive daytime sleepiness is a symptom of other sleep disorders and of depression, narcolepsy can be difficult to diagnose.
Diagnosis of narcolepsy can take a very long time, sometimes more than one year, or even longer.
Tests used to diagnose narcolepsy
Epworth Sleepiness Scale – This sleep questionnaire asks you to rank whether certain situations make you sleepy and, if so, how sleepy.
Nocturnal polysomnogram – This test will measure the electrical activity of your brain (electroencephalogram) and heart (electrocardiogram), and the movement of your muscles (electromyogram) and eyes (electro-oculogram), and usually requires an overnight stay at a sleep clinic for observation purposes.
Multiple sleep latency test (MSLT) – This test measures how long it takes for you to fall asleep during the day. People with narcolepsy tend to fall asleep very quickly. In addition, an abnormally quick progression to REM sleep is a strong indicator of narcolepsy.
Spinal fluid analysis – The lack of hypocretin in the cerebrospinal fluid may be a marker for narcolepsy. Examining spinal fluid is a new diagnostic test for narcolepsy.
Treatments for Narcolepsy
Although no cure yet exists for narcolepsy, a combination of treatments can control the symptoms. The most commonly recommended treatment for narcolepsy includes a combination of counseling, medication, and behavioral changes.
The treatments outlined below are for informational purposes only. Narcolepsy is a serious condition – it's important to consult with your physician to find the treatment that is best for you.
Individuals with narcolepsy find that a few brief, scheduled naps (no longer than 15 minutes at a time) during the day can prevent unplanned lapses into sleep during the daytime.
Avoid caffeine, alcohol, and nicotine
Stimulants and depressants can interfere with sleep cycles during your normal sleeping hours.
Exercise on a regular basis
Exercise can make you feel more awake during the day and stimulate normal sleep patterns at night.
Wear a medical alert bracelet or necklace
A medical ID is useful to alert others to your condition if you suddenly fall asleep or become unable to move or speak.
Medical Treatments for Narcolepsy
TREATMENT
DETAILS
Methylphenidate (such as Ritalin) and various amphetamines
Effective in treating narcolepsy but can have strong side effects and can be addictive.
Modafinil (Provigil)
A stimulant which acts on the central nervous system to help individuals stay alert and awake during the day. Effective, with not as many side effects. Chance of addiction is also lower than with amphetamines.
Antidepressants such as Vivactil, Prozac, and Zoloft
These drugs suppress REM sleep and alleviate the symptoms of cataplexy, hallucinations, and sleep paralysis.
Sodium oxybate (Xyrem)
Controls cataplexy and daytime sleepiness. Has strong side-effects.
