Narcolepsy & Hypersomnia: Symptoms, Causes & Treatment
If you're overwhelmingly sleepy during the day no matter how much rest you get, you may have a neurological sleep disorder like narcolepsy or hypersomnia.
Our neurologists evaluate sleep-wake disorders and guide testing, diagnosis, and treatment.
These conditions are real, diagnosable, and treatable. At Mir Neurology, our board-certified neurologists diagnose and manage disorders of excessive sleepiness for patients across Western Maryland, the Eastern Panhandle of West Virginia, and South-Central Pennsylvania.
Request an Appointment or call (301) 797-7600.
What Is Narcolepsy?
Narcolepsy is a chronic neurological disorder that affects the brain's ability to control the sleep-wake cycle. People with narcolepsy feel excessively sleepy during the day and may fall asleep suddenly, even in the middle of activities.
It is not a matter of being lazy or not getting enough sleep β it is a problem with how the brain regulates sleep, and in many cases it is linked to the loss of a brain chemical called hypocretin, or orexin, that helps keep us awake.
Narcolepsy Symptoms
Narcolepsy has several characteristic symptoms, though not everyone has all of them:
- Excessive daytime sleepiness β the main symptom; an overwhelming, persistent need to sleep during the day
- Sleep attacks β falling asleep suddenly and without warning
- Cataplexy β sudden, brief loss of muscle control triggered by strong emotions
- Sleep paralysis β a temporary inability to move or speak while falling asleep or waking up
- Hallucinations β vivid, dream-like experiences when falling asleep or waking
- Disrupted nighttime sleep β frequent awakenings despite being sleepy by day
What Is Cataplexy?
Cataplexy is one of the most distinctive features of narcolepsy. It is a sudden, temporary loss of muscle tone triggered by strong emotions β often laughter, surprise, or anger.
It can range from mild symptoms, such as brief eyelid sagging, slurred speech, or buckling knees, to a complete collapse while the person stays fully conscious. Cataplexy is caused by the same brain changes behind narcolepsy, and its presence helps determine the type of narcolepsy.
Types of Narcolepsy
Narcolepsy Type 1
Narcolepsy with cataplexy. It is associated with low levels of the brain chemical hypocretin.
Narcolepsy Type 2
Narcolepsy without cataplexy. Excessive daytime sleepiness is present, but cataplexy is not.
Identifying the type guides the most effective treatment approach.
What Is Hypersomnia?
Hypersomnia means excessive sleepiness or sleeping too much. It can be a symptom of narcolepsy, but it also occurs on its own.
Idiopathic hypersomnia is a distinct disorder in which a person feels excessively sleepy and struggles to wake up or feel refreshed despite plenty of sleep β but without the cataplexy or other specific features of narcolepsy.
Because the symptoms overlap, distinguishing idiopathic hypersomnia from narcolepsy requires careful evaluation and sleep testing.
What Causes Narcolepsy?
In narcolepsy type 1, symptoms are linked to the loss of brain cells that produce hypocretin, also called orexin, a chemical that helps regulate wakefulness. This loss is thought to involve an autoimmune process in many cases.
Other contributing factors may include:
- Genetics β certain genes increase susceptibility, though narcolepsy is not usually directly inherited
- Immune system factors β the body mistakenly affecting hypocretin-producing cells
- Triggers β in some cases, infections or other events may play a role
Is narcolepsy genetic? There is a genetic component that raises risk, but most people with the associated genes never develop narcolepsy, and it rarely runs straightforwardly in families.
How Narcolepsy and Hypersomnia Are Diagnosed
Because excessive sleepiness has many causes, an accurate diagnosis is essential. Evaluation typically includes:
- A detailed sleep history and review of symptoms, including any cataplexy
- Questionnaires measuring daytime sleepiness
- A sleep study, also called polysomnography, which is an overnight test of your sleep
- A multiple sleep latency test, or MSLT, which is a daytime test measuring how quickly you fall asleep and enter REM sleep
- Additional testing when needed to rule out other causes
A neurologist coordinates and interprets these tests to reach the right diagnosis.
Treatment for Narcolepsy and Hypersomnia
While there is no cure for narcolepsy, symptoms can be managed effectively, allowing people to lead active, productive lives. Treatment is tailored to your symptoms and type and may include:
- Medications to reduce daytime sleepiness and improve wakefulness
- Medications to manage cataplexy and other symptoms when present
- Scheduled short naps strategically placed during the day
- Good sleep habits, including consistent sleep schedules and a healthy sleep environment
- Lifestyle adjustments and safety guidance, including driving considerations
- Ongoing follow-up to fine-tune treatment over time
The goal is to control daytime sleepiness and other symptoms so you can function fully at work, school, and home.
When to See a Neurologist
Consider an evaluation if you have persistent excessive daytime sleepiness that interferes with your life, episodes of falling asleep suddenly, muscle weakness triggered by emotions, or sleep paralysis. These symptoms deserve a proper diagnosis β and effective treatment is available.
At Mir Neurology, our board-certified neurologists evaluate and treat narcolepsy, hypersomnia, and other sleep-related neurological disorders. With offices in Cumberland and Hagerstown, expert care is close to home. See also our Insomnia & Sleep Disorders page.
Serving Western Maryland & the Tri-State Area
With offices in Cumberland and Hagerstown, Mir Neurology provides evaluation and treatment for excessive daytime sleepiness, narcolepsy, and hypersomnia close to home.
Maryland
Cumberland, Hagerstown, LaVale, Frostburg, Cresaptown, Hancock, Williamsport, Smithsburg, Boonsboro
West Virginia
Martinsburg, Keyser, Romney, Berkeley Springs, Paw Paw
Pennsylvania
Waynesboro, Greencastle, Chambersburg, Mercersburg
Cumberland office: 924 Seton Dr Suite C, Cumberland, MD 21502 β MonβSat, 7:30 AM β 4:30 PM
Hagerstown office: 11110 Medical Campus Rd Unit 151, Hagerstown, MD 21742 β MonβFri, 7:30 AM β 5:00 PM
Frequently Asked Questions
What is narcolepsy?
Narcolepsy is a chronic neurological disorder in which the brain cannot properly regulate the sleep-wake cycle, causing excessive daytime sleepiness and sometimes sudden sleep attacks, cataplexy, and sleep paralysis.
What is cataplexy?
Cataplexy is a sudden, brief loss of muscle tone triggered by strong emotions like laughter or surprise. It can range from slight weakness to a full collapse while the person remains conscious. It is a hallmark of narcolepsy type 1.
What is the difference between narcolepsy and idiopathic hypersomnia?
Both cause excessive daytime sleepiness, but narcolepsy can include cataplexy, sleep attacks, and REM-related symptoms, while idiopathic hypersomnia involves excessive sleep without those specific features. Sleep testing helps tell them apart.
Is narcolepsy genetic?
There is a genetic component that raises risk, but most people with the related genes never develop it, and it does not usually run straightforwardly in families.
How is narcolepsy diagnosed?
Through a sleep history, questionnaires, an overnight sleep study called polysomnography, and a daytime multiple sleep latency test, interpreted by a specialist.
Struggling With Overwhelming Daytime Sleepiness?
It could be a treatable neurological sleep disorder. Mir Neurology diagnoses and treats narcolepsy and hypersomnia in Cumberland and Hagerstown.