Fascinating Things About Narcolepsy Most People Don't Know

Narcolepsy is a chronic sleep disorder that is characterized by constant drowsiness or the persistent feeling of needing to sleep during the day time. People may also have sudden attacks of needing to sleep, or falling asleep uncontrollably (but not without warning). People who have narcolepsy frequently have issues staying awake for long periods of time, and have a sporadic sleep wake schedule compared to the rest of the world. A person with narcolepsy may require a very different routine than the average human, and may simply need to sleep at various intervals during the day, no matter what is going on around them.

The condition was discovered way back in the 1600s, by an Oxford physician named Thomas Willis. Willis did not name or fully understand the cause of the condition, but he did note that some people were always sleepy or needed to sleep in an irregular pattern throughout the day. Later, in 1880, a French doctor named Gélineau called it a medical disorder, naming it "narcolepsie." When broken down, this word roughly translates to "sleep attack," a term that is still sometimes appropriate to narcoleptics even today.

Most people may know the basics of what narcolepsy is, but few actually know that there are two separate types of the disorder. Type 1 narcolepsy, formerly known as narcolepsy with cataplexy, happens when a person has low levels of of a hormone called hypocretin in their brain. Hypocretin is a neuropeptide that is in charge of the body's wakefulness, appetite, and arousal. These individuals may also experience sudden loss of their muscles, also due to the lack of hypocretin, and may collapse onto the ground or slump to the side in their seat. This is the most common type of narcolepsy.

The other kind, Type 2 narcolepsy, happens when people experience constant sleepiness during the day time, but lack the muscle weakness that makes them collapse or lose control of their body. This type of narcolepsy tends to be less severe, and people who experience it have fairly normal levels of hypocretin in their brain. This is also more commonly linked to an injury to the brain that causes issues in regulating sleep. Some side effects of Type 2 narcolepsy can include more severe neurological issues. Both kinds are neurological disorders, and both levels of the condition can cause serious disruptions in a person's life.

The way narcolepsy has been portrayed in media has given power to a whole lot of myths about how narcolepsy really works. Narcolepsy is often portrayed as a harmless and merely annoying disorder, almost like a silly quirk of someone's personality. In reality, it can be incredibly damaging to a person's life. The other big misconception is that narcoleptics just fall asleep without any warning. While people with narcolepsy do suffer from sleep attacks, they will always have some degree of warning, and the majority of narcoleptics do not suffer from uncontrollable spontaneous sleeping.

A more subtle difference between myth and reality is the idea that narcoleptics sleep all the time. In truth, narcoleptics sleep about the same amount as anyone else, it's just that their sleep wake schedule is broken up into smaller parts, and different than the average person. Just because someone naps a lot and gets sleepy at work does not make them a narcoleptic, and it's a disorder that should not be taken lightly. 

Another common misconception about this condition is that it is a rare one. While it isn't as common as being left-handed, it's still a lot more common than people think. Symptoms initially begin in childhood or adolescence, with narcolepsy being diagnosed mostly between age seven and twenty five. It happens about equally in men and women, and happens all over the world. In the United States alone, it is estimated that right now 135,000 to 200,000  individuals live with narcolepsy. That means that roughly one in every two thousand people are diagnosed with the disorder.

The bad news is this disorder is often undiagnosed or misdiagnosed, with symptoms being mistaken for other issues, such as seizures. The number of people affected by the disease may be much higher.

So, why does narcolepsy happen, and why does it impact people the way it does? To put it simply, it's all in your head. That's not to say you're imagining it! This disorder actually has everything to do with brain chemistry.

For people with narcolepsy Type 1, their brain tends to have issues with a lack of hypocretin, a chemical which promotes feelings of being awake, as well as regulation of REM sleep. For Type 2, those levels may be normal, but part of the brain that has to do with sleep may be malfunctioning, or is damaged.  

It is still not completely understood how narcolepsy happens, but we do know a few contributing causes. Autoimmune disorders can cause a loss of hypocretin, possibly because a person's body may be attacking the brain cells that contain and produce the hormone. Clusters of narcolepsy do sometimes pop up in families, indicating that there may be a genetic predisposition. Another possible cause of narcolepsy is a brain injury that can hinder the function that contributes to REM sleep and sleep wake cycles. This is rare, but it has been known to happen.

So, what does it feel like to have narcolepsy? For one thing, every case of narcolepsy is slightly different, so no two people experience it the same way. One person may have severe symptoms while it flies under the radar for another person. But assuming you have a more "classic" case, we can imagine how everything might go. 

All individuals with narcolepsy experience some form of excessive daytime sleepiness, or EDS. This symptom means that you will feel persistently sleepy while you are awake, no matter how much sleep you get during both the day and night. In some cases, this sleepiness might hit you all at once in an "attack." These attacks are not without warning, but they can be debilitating, because the feeling is overwhelming and can't really be stopped once it starts. When these attacks are not taking place, people with narcolepsy may seem normal, alert, and attentive. When the attacks or swells of sleepiness are happening, it can be hard to focus or even function.