Narcolepsy and mental health
A person with narcolepsy may find significant impact to their mental health. There are recorded increased instances of anxiety, panic attacks and social phobias amongst people who suffer with narcolepsy. This is currently understood to be as a direct result of the impact of narcolepsy on everyday living.

A person with narcolepsy who is experiencing reduced quality and fragmented sleep may experience all the emotional and behaviour symptoms of exhaustion

• Irritability

• Reduced control over emotions

• Reduced motivation

• Anger

• Apathy

In children, an increase in violence and/or self-harm has been recorded, where the child is overwhelmed with emotion and exhaustion.

Narcolepsy and appetite
A person with narcolepsy may find it much more difficult to regulate their appetite. In addition to craving sugar and energy to function when the body and mind are exhausted, the same changes to the brain that impact the ability to regulate sleep also can impact the ability to regulate appetite. There is an increased risk of obesity for a person that suffers with narcolepsy

Narcolepsy and Education
Narcolepsy does not affect intelligence. A person with narcolepsy can perform very well in education, however the symptoms of narcolepsy may have a significant impact on a person’s ability to learn. As narcolepsy typically develops during childhood and teen years, support in education is vital for sufferers narcolepsy. A person with narcolepsy may find it much harder to stay focused and alert in class, may need to take regular sleep intervals, and may need adaptations and support during exams.

Support in education can include

• SNA for younger children to help manage symptoms, emotions, routine and medication

• Allowances and facilities for scheduled naps

• Understanding of narcolepsy amongst teaching and support staff

• Increased time for to allow students to complete exam

Day and Night sleep
Narcolepsy effects the brain’s ability to manage sleep and wakefulness. This symptom is experienced both during the day and at night. For someone without narcolepsy a typical night’s sleep will include two types of sleep: REM and non-REM (NREM). These two types of sleep are separates distinct stages. Dreams occur during REM sleep. During this stage the body is paralysed to prevent it acting out the dream.

Night
In someone with narcolepsy these two stages are less distinct and often blurred, leading to a more disturbed, fragmented and less restful, restorative sleep.

• Sleep paralysis is common, where the person is awake but the body is still paralysed as it would be during REM sleep.

• A person with narcolepsy may also experience vivid and often frightening hallucinations when waking. This is a symptom of the blurred line between the REM, non-REM (NREM) and waking state.

• A person with narcolepsy may cycle in an out of REM sleep much more often. 

• Insomnia is common feature of narcolepsy. Someone who suffers with narcolepsy can find it very difficult to fall asleep at night.

Day
The fragmented, reduced-quality of the night-time sleep, in addition to one of the main symptoms of narcolepsy - the reduced ability of the brain to manage the boundary between waking and sleepiness – results in sleep appearing during waking hours.

A person with narcolepsy is likely to experience

• Episodes of uncontrollable sleepiness during the day - also known as Excessive Daytime Sleepiness. A person with narcolepsy may find themselves falling asleep without control, or experiencing ‘Sleep Attacks’ throughout the day.

• Feeling extremely tired or exhausted after what appears to be a full night’s sleep. This is due to the reduced quality of sleep and the fragmented nature of the sleep

• Episodes of automatic behaviour during the day. Automatic behaviour is repetitive actions with are performed without awareness.

• With narcolepsy type 1 a person can also experience cataplexy which is a sudden loss of muscle control, often trigger by an emotional response like laughter. Cataplexy is thought to be triggered by the REM function of paralysing the body during REM sleep.

See Narcolepsy Symptoms for further details