When you have narcolepsy, your body's sleep-wake cycle doesn't work the way it should. Certain changes in the brain make it more difficult to manage your sleep. One of the main symptoms is daytime sleepiness. You may also have:
- hallucination
- Muscles lose control for minutes at a time
- Sleep paralysis, which means you are unable to move when you fall asleep or when you first wake up
Narcolepsy often co-occurs with mental health conditions such as depression or anxiety. Researchers are still figuring out the connection between narcolepsy and mental health.
Depression is the mental health problem most commonly associated with narcolepsy. Surveys show that up to 57% of narcolepsy patients report feeling depressed. By comparison, 4.7% of U.S. adults said they often feel depressed.
Anxiety disorders are also common in people with narcolepsy. One study found that about 35% of people with narcolepsy also have anxiety problems, such as panic attacks and social phobia. This compares to about 18% in the general population .
In some cases, people develop mental health problems as a result of narcolepsy. It can affect your ability to study, work, drive and enjoy hobbies.
Disrupted sleep can also change your personality. Narcolepsy can take a toll on your relationships. Studies show that narcolepsy is associated with higher unemployment, missed work time, lower wages and marital problems.
On the surface, attention deficit hyperactivity disorder (ADHD) appears to be the opposite of narcolepsy. You might think of someone with ADHD as "hyper" rather than sleepy. But scientists believe there is a connection. One study found that children with narcolepsy were more likely to develop ADHD symptoms than children with regular sleep patterns.
People with narcolepsy are also at risk for eating disorders, especially overeating and abnormal food cravings. In one study, about a quarter of people with narcolepsy met criteria for an eating disorder.
Schizophrenia and narcolepsy share some symptoms, including hallucinations. Researchers studied people who had both symptoms. Their problems usually begin in childhood or adolescence. But being diagnosed with schizophrenia and narcolepsy at the same time appears to be quite rare.
In the United States, narcolepsy is a disabling disorder characterized by pathological daytime sleepiness manifested by a recurring tendency to fall asleep frequently, often triggering unintentional naps or falling asleep throughout the day. Cataplexy, a sudden loss of muscle tone triggered by emotions, may also occur. Symptoms of narcolepsy first appear in late adolescence or early adulthood, and because it is a chronic condition that often requires lifelong treatment, it can have profound effects on functioning, quality of life, and health care costs.
Patients with narcolepsy have a high prevalence of comorbidities . Up to 15% of people with narcolepsy have restless legs syndrome, and an estimated 25% of people with narcolepsy have sleep apnea. Psychiatric disorders are also common in patients with narcolepsy, especially mood disorders (depression and anxiety); comorbidities such as chronic pain, gastrointestinal disorders, hypercholesterolemia, and hypertension are also common. Studies have shown that narcolepsy has a mortality rate that is approximately 1.5 times higher than that of people without narcolepsy .
Peaks in the relative risk of death were observed in the 25-34 and 35-44 age groups, with higher relative risk in older age groups. Narcolepsy usually occurs in late adolescence or early adulthood, and it takes an average of 7 to 10 years after the first symptoms to be diagnosed. Over time, health-related quality of life in patients with narcolepsy often improves due to adaptive strategies, but because patients are past their peak productivity, some of the peaks may be the result of suicide due to decreased health-related quality of life. and comorbid depression.
Adolescents are particularly vulnerable to sleep-related risks and suicidal thoughts and behaviors (STB), and sleep deprivation may impair cognitive, emotional, physical, and social functioning.
Studies report that only 0.32% of emergency department visits in the United States have documented sleep disorders. In contrast, survey data show that the prevalence rate of insomnia among American teenagers is 9%, and the prevalence rate of suspected sleep apnea is 6%. Relative to estimates of the prevalence of sleep disorders in national surveys, sleep disorders are significantly underdiagnosed among adolescents presenting to emergency rooms, reflecting larger deficiencies in health care. Healthcare training programs and accrediting agencies can increase the likelihood of accurate diagnosis of sleep disorders by requiring education about the high prevalence of sleep disorders, the impact of sleep disorders on mental and physical health, and the diagnosis and treatment of sleep disorders.
Research shows that depression, depressive symptoms, suicidal thoughts, and suicide risk are common in patients with narcolepsy type 1 (NT1), especially in untreated patients, and are related to NT1 severity. Depressive symptoms and suicidal thoughts improved after NT1 drug treatment. Patients with suicidal thoughts were more likely to be male .
