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Narcolepsy Due to Medical Condition

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What is it?

This sleep disorder occurs when an underlying medical problem causes you to have narcolepsy. Narcolepsy is a sleep disorder that usually involves the following symptoms:

  • Sleep attacks
  • “Cataplexy” - attacks of muscle weakness
  • Sleep paralysis
  • Hallucinations as you are about to fall asleep

Who gets it?

In rare cases, people with a disease that affects the brainstem will get this condition. The disease causes damage to the brain system from areas in which dream sleep originates. This results in narcolepsy.
Diseases that may cause narcolepsy include the following:

  • Multiple sclerosis
  • Myotonic dystrophy
  • Parkinson disease
  • Sarcoidosis

How do I know if I have it?

  1. Do you have an ongoing medical problem?
  2. Do you suffer from any of these problems?
  • Sleep attacks
  • Attacks of muscle weakness
  • Sleep paralysis
  • Hallucinations as you are about to fall asleep

If you answered “yes” to both of these questions, then you may have narcolepsy due to medical condition. The only way to know for sure is to see your doctor.

Do I need to see a sleep specialist?

Yes. This condition requires the expertise of a doctor who is trained in complex sleep disorders. The sleep doctor will know what testing needs to be done. He or she will be able to find the cause of your problem and help you obtain the best medical treatment.

What will the doctor need to know?

The doctor will need a complete medical history. Tell him or her about any medical problem that has ever affected your brain or nerves. The doctor will need to know these details:

  • When the medical problems started
  • What symptoms you had
  • What treatments you used
  • How well you responded to treatment

Also tell the doctor about any of the narcolepsy symptoms that you have. It will help to know when these problems began in relation to your medical condition.

Will I need to take any tests?

To know for sure if you have narcolepsy, you will need to do two sleep studies:

  1. Overnight Sleep Study

Also called a polysomnogram, this study records a full night of sleep.

  1. Multiple Sleep Latency Test (MSLT)

This is a daytime sleep study that records at least four naps.

The polysomnogram will chart your brain waves, heart beat, and breathing as you sleep. It will also record how your arms and legs move. This will show if there are other problems that are causing your sleep attacks. Two examples of these problems are sleep apnea and periodic limb movement disorder.

People who have narcolepsy tend to fall asleep at unusual times during the day. The MSLT will measure how fast you fall asleep during the day. It will also show what kind of sleep you have when you take a nap. The MSLT also shows whether or not you dream. Adults usually do not dream when napping during the day.

How is it treated?

The first step is to treat the underlying medical condition. If narcolepsy persists, then separate treatment will be needed.

The most common way to treat narcolepsy is to use a medication. Your doctor will most likely want you to take a stimulant that helps you stay awake during the day. There are a variety of stimulants that can be used. It may take some time for your doctor to find the right medication for you. He or she will also need to find the right dosage to control your symptoms.

You may have narcolepsy with cataplexy. In this case, a doctor will use a different kind of drug to treat your muscle weakness.

By David A. Kristo , MD
Updated March 24, 2006

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