Q. My niece was just diagnosed with narcolepsy. It must have something to do with the brain. What can you tell me?

A. Yes, it does have something to do with the brain—almost everything does! Narcolepsy is a neurological disorder related to the control of sleep and wakefulness. Think of it as REM (rapid eye movement) sleep that suddenly interferes with a waking state. The sleep state can occur anytime: while eating, exercising, driving a vehicle, studying/working, or talking on the telephone. Consequently, the results can range from inconvenient to dangerous, especially when the disorder is not properly diagnosed and treated.

Some have suggested that narcolepsy is really an autoimmune disease that affects brain tissue. It definitely is much more complex than a simple sleep disorder, so called. Studies have shown a deficiency in the brain of hypocretin, a neuropeptide ligand (information substance) associated with the hypothalamus, such as regulation of energy and a variety of neuroendocrine functions.

Narcolepsy affects approximately 1 in every 2000 persons. Symptoms usually begin between ages 15 and 30. The type of symptoms, as well as their severity, can differ widely among individuals and can include:

• A tendency to fall asleep suddenly during the day for a few seconds to more than 30 minutes
• Sudden brief episodes of muscle weakness so that the person falls to the ground or drops whatever he/she was carrying (often triggered by strong emotions such as anger, surprise, laughter, or anticipation)
• A temporary inability to move or speak during the transition from sleep to awakeness or vice versa
• Disturbed night-time sleep (e.g., leg jerks, nightmares, tossing and turning in bed, waking frequently)
• Dream-like hallucinatory images that can resemble a nightmare and typically occur at onset of sleep

While there is no known cure for narcolepsy currently, individuals can enjoy near-normal lifestyles if they receive early and accurate diagnosis, appropriate treatment, and support from family members, teachers, friends, employers, and others. Medical and behavioral and therapies can be very helpful, although treatment does not necessarily alleviate all symptoms completely.

You may want to visit the Narcolepsy Information Page at the NIDS (National Institute of Neurological Disorders and Stroke) website for additional information.