Narcolepsy is a rare neurological disorder characterized by extreme daytime sleepiness and falling asleep at inappropriate times. It is caused by the brain’s inability to control the wake/sleep cycle. Narcolepsy causes ‘sleep attacks’ that can occur during any activity at any time throughout the day making it particularly dangerous to drive. Sleep attacks are not limited to times of low energy or little activity, they can occur during work or school, in the middle of a conversation, eating dinner, while exercising or playing a sport. The duration of a sleep attack can range from a few seconds to several minutes.


The most common symptom of narcolepsy is excessive daytime sleepiness (EDS). This symptom is often the first to appear usually between the ages of 10 and 20 years old. Excessive daytime sleepiness occurs independently of the amount of rest you get at night. Patients can experience mental fogginess, lack of energy and concentration, a depressed mood and extreme exhaustion. EDS may begin to interfere with a person’s daily activities. Other symptoms of narcolepsy include:

  • Hallucinations – People who suffer with narcolepsy can experience frightening and vivid hallucinations during times when they are falling asleep (hypnagogic) or waking from sleep (hypnopompic) 
  • Cataplexy is the loss of voluntary muscle control during a person’s wake cycle such that they are completely conscious of the event, but unable to control it. Cataplexy can range from drooping eyelids and slurred speech to complete loss of muscle tone causing a person to fall and be unable to move or speak. Cataplexy can be triggered by intense emotions such as surprise, fear, anger or stress and anxiety
  • Sleep paralysis is the temporary inability to move or speak while falling asleep or waking. A person in sleep paralysis is conscious of their surroundings, but feels completely paralyzed because their body is still in the REM cycle of sleep. Sleep paralysis usually lasts a few seconds to a few minutes with no permanent effects 

Diagnosing narcolepsy involves participating in overnight sleep study testing to ensure there is not another condition affecting sleep as well as a daytime nap test (called a Multiple Sleep Latency Test) that objectively measures your sleepiness throughout the day. The data from these two tests can confirm the diagnosis of narcolepsy.


If you have symptoms of narcolepsy, it is important to be evaluated by a sleep medicine specialist to help determine what treatment will be best for you. While there is no known cure for narcolepsy, Pulmonary Associates of Richmond can offer certain medications to help control your symptoms. We also encourage patients to make small lifestyle changes that can help manage this sleep disorder, such as:

  • Avoid caffeine, alcohol, nicotine and other stimulants
  • Avoid eating heavy meals late in the evening
  • Short daytime naps
  • Regular exercise