Narcolepsy: Diagnosis, Causes and Treatments

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Narcolepsy is a sleep disorder caused by neurological changes that leads to difficulties regulating ones sleep-wake cycle. It can be seen in sudden sleep ‘attacks’ that can’t be controlled and cataplexy, which is when the individual suddenly loses muscle tone.


Narcolepsy is diagnosed in the Diagnostic and Statistical manual of mental disorders (APA 2013) according to the following criteria:

  • Recurrent periods of an irrepressible need to sleep, lapsing into sleep, or napping occurring within the same day. These must have been occurring at least 3 times per week over the past 3 months.

The presence of at least one of the following:

  • Episodes of cataplexy, occurring at least a few times per month, and as defined by either:
  • In individuals with long-standing disease, brief (sec to min) episodes of sudden, bilateral loss of muscle tone with maintained consciousness that are precipitated by laughter or joking
  • In children or in individuals within 6 months of onset, spontaneous grimaces or jaw-opening episodes with tongue thrusting or global hypotonia, without any obvious emotional triggers.
  • Hypocretin deficiency, as measured by cerebrospinal fluid (CSF) hypocretin-immunoreactivity values of one-third or less of those obtained in healthy subjects using the same assay, or 110 pg/mL or less.
  • Nocturnal sleep polysomnography (PSG) showing rapid eye movement (REM) sleep latency of 15 minutes or less, or a multiple sleep latency test (MSLT) showing a mean sleep latency of 8 minutes or less and more than 2 sleep onset rapid eye movement periods (SOREMPs).
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Narcolepsy can cause significant difficulties and dangers in everyday life and unfortunately there is no cure, but the are changes that can be made to help to alleviate symptoms. These include:

Lifestyle Changes:

  • Diet: Eat a balanced diet with whole foods and limited processed foods, eating regularly throughout the day and not immediately before bed. Avoid caffeine, nicotine and alcohol as these disturb sleep
  • Regular Exercise: This aids with forming healthy sleep patterns and general wellbeing
  • Take Naps: By scheduling naps, you can reduce the risk of sudden ‘sleep attacks’
  • Talk to others: Narcolepsy is a misunderstood illness and explaining it to those close to you helps form a base of support


  • Stimulants such as modafinil can help individuals stay awake for longer during the day but may bring adverse side effects such as nausea and anxiety
  • Antidepressants such as selective serotonin reuptake inhibitors help to reduce narcolepsy episodes by reducing the amount of rapid eye movement sleep. Other antidepressants used include serotonin-noradrenaline reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs)


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Anderson, T., Bandi, M., Bromley, K. D., Nino, M., & Terekhov, K. (2003). Narcolepsy.

M. Billiard, V. Pasquié-Magnetto, M. Heckman, B. Carlander, A. Besset, Z. Zachariev, J. F. Eliaou, A. Malafosse, Family Studies in Narcolepsy, Sleep, Volume 17, Issue suppl_8, December 1994, Pages S54–S59,

Mehta, R., Jiwanji, M., Singhal, R., Gillam, E., Lockwood, K., & Quarmley, M. (2021). The Social and Emotional Toll of Narcolepsy. Undergraduate Works.

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