Narcolepsy in Children

What is narcolepsy?

Narcolepsy is a neurological disorder which causes excessive daytime sleepiness and, in some cases, more serious symptoms such as sleep attacks and sleep paralysis.

Anatomy of narcolepsy

Narcolepsy occurs when the part of the brain controlling sleep and wakefulness malfunctions, sending the patient into the REM (rapid eye movement) stage of sleep without warning.

What Causes Childhood Narcolepsy?

The primary cause of narcolepsy is unknown but it has been linked to a lack of a particular chemical in the brain, orexin (or hypocretin), which regulates sleep.

There have been cases of narcolepsy, however, in patients with normal levels of orexin. Medical scientists believe that the following conditions may be triggers for both autoimmune diseases and narcolepsy:

  • Hormonal changes (i.e. puberty or menopause)
  • Psychological stress
  • Hereditary genetic faults
  • Changing patterns of sleep (i.e. shift work)
  • Infection

Studies have found that narcolepsy is most likely to occur in early adulthood but it can occur in children.

What are the Symptoms of Narcolepsy?

  • Excessive daytime sleepiness
    • Feeling drowsy during the day
    • Struggling to stay awake
  • Sleep Attacks
    • Falling asleep suddenly (i.e. In the middle of a conversation)
    • Individuals may have micro sleeps (which last for several seconds) or naps which can last several minutes
    • May occur several times a day
  • Loss of muscle control of muscle weakness (cataplexy)
    • Mouth falling open
    • Head slumping
    • Slurred speech
    • Double vision or difficulty focusing
  • Sleep paralysis
    • Inability to move or speak as you wake or start to fall asleep
    • Episode may last several minutes.
    • Not physically harmful, but can be terrifying

Patients suffering from narcolepsy have also reported the following symptoms:

  • Hallucinations
  • Nightmares
  • Headaches
  • Interrupted or restless sleep
  • Memory loss
  • Depression

How is Narcolepsy Diagnosed?

You should take your child to should yourGP is they are suffering from any of the conditions listed above.

The GP will run a number of tests and examinations in order to eliminate other possible causes of symptoms.

If the GP suspects that your child is suffering from narcolepsy they will refer them to a sleep specialist. Following a nighttime sleep study patients will then undergo a multiple sleep latency test.

During a multiple sleep latency test your child will be required to nap every two hours. The patient is given twenty minutes to try and fall asleep.

The sleep specialist will measure two elements:

  • How quickly you fall asleep
  • How quickly you enter the REM stage of sleep

Patients may also have their Orexin levels measured, which is accomplished through the administration of a lumbar puncture, which removes a sample of cerebrospinal fluid for testing.

Why should I treat my Child’s Narcolepsy?

Narcolepsy is a serious condition with potentially debilitating symptoms for your child. There is no cure for narcolepsy but with treatment most children can lead a near normal life.

Treatments for Narcolepsy in Children?

There are no known cures for narcolepsy but doctors may prescribe the following treatments to help alleviate symptoms:

  • Stimulants (help patients stay awake during the day)
  • Sodium oxybate (reduce cataplexy and daytime sleepiness)
  • Antidepressants (to treat a variety of symptoms such as hallucinations, sleep paralysis and cataplexy)

Doctors and sleep specialist may also advise patients to make certain lifestyle changes including:

  • The adoption of good sleeping habits (i.e. Sleeping positions, routines)
  • Daytime napping (no more than 10-15 minutes at a time)
  • Reduction or elimination of alcohol and caffeine consumption
  • Regular exercise
  • Avoiding large meals before bed

Patients may also find it helpful to join a support group or see a therapist so that they can address and discuss some of the more frightening aspects of narcolepsy (i.e. Sleep attacks, loss of muscle control and sleep paralysis).