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Sleep Care

Narcolepsy: Health Risks and Co-Morbidities

Narcolepsy can sometimes be a difficult illness to diagnose, as there are a number of other health problems that can produce similar symptoms and must be considered during evaluation.  In some cases, these other disorders occur as co-morbidities to a person suffering from narcolepsy.  A common co-morbidity is sleep apnea, where breathing stoppages occurring during the night prevent the brain from getting a good night’s rest and often result in the daytime fatigue and tiredness, which is a chief symptom of narcolepsy.  Narcolepsy can result in problems with normal functioning at school or work, as well as some behavior changes—symptoms which are shared with a number of psychiatric disorders, such as major depression or bipolar disorder.  In the course of treating these psychiatric disorders, the medications used can cause hypersomnia (increased tiredness), which can further complicate evaluations for narcolepsy.  Schizophrenia is another mental disorder that shares symptoms with narcolepsy, particular the hallucinations that narcoleptic patients sometime experience when drifting in and out of consciousness.

Co-morbidities can also arise depending on the apparent cause of narcolepsy, such as when narcolepsy occurs because of a brain lesion or other damage.  In these cases, neurologic disorders such as epilepsy, Parkinson’s, or Alzheimer’s may also be present and make the narcoleptic symptoms more severe.  Treatments in these situations typically combine methods for both diseases simultaneously, as opposed to trying to treat one disease before the other.

Narcolepsy may be secondary to some genetic diseases, such as Prader-Willi syndrome and myoclonic dystrophy, both of which affect muscle tone, or Neimann-Pick disease type C, which affects liver functioning.

Health Risks of Narcolepsy

The health risks of narcolepsy can be broken down into a couple of categories.  The excessive daytime sleepiness and poor muscle composure characteristic of more severe cases of narcolepsy can result in reduced exercise and physical activity, which leads to lower metabolism levels and obesity (in most people).  Interestingly, there may also be a more narcolepsy-specific component to weight gain in those suffering from narcolepsy: a 2003 study investigating the weights of narcoleptics versus those suffering from daytime tiredness (but not narcolepsy) found that narcoleptics had greater stores of excess body fat (and a higher frequency of obesity)—despite similar low levels of physical activity between the two groups.

Difficulty focusing and functioning at school, work, and in relationships impairs one’s ability to have a healthy emotional, social, and work life.  It also impacts earning potentials:  A 2009 study of the economic impact of narcolepsy found that those suffering from it had significantly higher healthcare and medication expenses, as well as unemployment rates, than a control group.  For those with narcolepsy who were employed, their earned income was significantly lower.

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