The sight of someone dropping off to sleep in midsentence might seem humorous when portrayed in the realm of entertainment, but there is nothing funny about narcolepsy. In fact, after obstructive sleep apnea, narcolepsy is the second-leading cause of excessive daytime sleepiness diagnosed by sleep centers, affecting one in 2,000 people.

Narcolepsy is a cause of daytime sleepiness due to a disorder of the control of dreaming (or REM sleep).It should be differentiated from sleep apnea, periodic leg movements and other rarer causes of daytime sleepiness.

Excessive daytime sleepiness is usually the first symptom of narcolepsy to appear and can sometimes be differentiated from similar symptoms in other illnesses by how overwhelming it can be to the patient. The need to sleep tends to occur at times when the patient wants to be awake. These sleep attacks can last as briefly as 30 seconds or as long as 30 minutes or more. Such excessive sleepiness may even segue into regular episodes of cataplexy, a striking and sudden loss of muscle control ranging from slight weakness to total collapse.

While the exact cause of narcolepsy is still unknown, some recent studies show that narcoleptics lack the chemical hypocretin, which stimulates arousal and helps regulate sleep. Narcoleptics also have a reduced number of Hcrt cells, neurons that secrete hypocretin. This may be due to a degenerative process or an immune response. Some studies also show that narcolepsy may be an inherited disorder. In fact, children of narcoleptics have a one in 20 chance of being afflicted with narcolepsy, and nearly 75 percent of first-degree relatives of narcoleptics also have narcolepsy or some other sleeping disorder.

While general practitioners may be familiar with the symptoms, diagnostic procedures and treatments relating to narcolepsy, a sleep specialist has specific expertise in this arena.

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