Narcolepsy: Misdiagnosis and New Potential Treatments

Narcolepsy is a neurologic disorder that is most often characterized by excessive daytime sleepiness. People with narcolepsy may have a sudden onset of sleepiness and may not be able to maintain wakefulness throughout the day. Often if the diagnosis is not made these people may be diagnosed with a psychiatric disorder or sometimes labeled lazy. Not only are people with narcolepsy misdiagnosed but people who have depression, other sleep disorders, or medical reasons for daytime sleepiness have been labeled as having narcolepsy without the necessary medical testing. 

Other symptoms associated with narcolepsy may include poor nighttime sleep and the onset of dreams while falling asleep or waking up. 

Sleep paralysis is waking up with the inability to move for a minute or two. Cataplexy is the sudden loss of muscle strength in the part of your body. This frequently occurs in association with emotion. Elation is the most common emotion to elicit this response, but many different emotions can bring this out. People have been labeled clumsy when this diagnosis is not made.

When narcolepsy and cataplexy occur together this is called Type 1 narcolepsy. Narcolepsy which occurs without cataplexy it is called Type 2 narcolepsy. The onset of narcolepsy has two peaks in adolescence and in the mid-thirties. The incidence of narcolepsy is unknown because it is often misdiagnosed, but the estimated incidence is at least 1/2000 persons in the United States. Narcolepsy is believed to have more than one cause. Genetics plays a role and so does an autoimmune disorder where the cells which make a certain chemical, orexin, in the brain are damaged. Brain trauma has also been associated with the development of narcolepsy. 

Treatment for narcolepsy is twofold: behavioral and medicines. The goal of behavioral therapy is to minimize the symptoms of narcolepsy interfering with our lifestyle. This includes a regular sleep-wake time, naps during the day, and avoiding large meals which may make you sleepy. The goal of medicinal therapy is to decrease daytime sleepiness and cataplexy symptoms. New medicines are being developed to treat both Type 1 narcolepsy and Type 2 narcolepsy. 

Clinical Site Partners Miami and Clinical Site Partners Orlando are participating in clinical trials of medicines to treat Type 1 & 2 narcolepsy. For more information view current trials here or call 305-255-7452 (Miami) or 407-740-8078 (Orlando).