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Causes
By Mayo Clinic staffThe exact cause of narcolepsy isn't known. Genetics may play a role. Other factors, such as infection, stress or exposure to toxins, may contribute to the development of narcolepsy.
Normal sleep pattern vs. narcolepsy
The normal process of falling asleep begins with a phase called non-rapid eye movement (NREM) sleep. During this phase, your brain waves slow considerably. After an hour or two of NREM sleep, your brain activity picks up again, and REM sleep begins. Most dreaming occurs during REM sleep.
In narcolepsy, however, you may suddenly enter into REM sleep without first experiencing NREM sleep, both at night and during the day. Some of the characteristics of REM sleep, such as sudden lack of muscle tone, sleep paralysis and vivid dreams, occur during other sleep stages in people with narcolepsy.
The role of brain chemicals
Hypocretin is an important chemical in your brain that helps regulate wakefulness and REM sleep. People with narcolepsy have low levels of this neurochemical in their spinal fluid. It's particularly low in those who experience cataplexy. Exactly what causes the loss of hypocretin-producing cells in the brain isn't known, but experts suspect it's due to an autoimmune reaction.
- Narcolepsy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/health_and_medical/pubs/narcolepsy.htm. Accessed April 8, 2010.
- Scammel T. Diagnosis and neurobiology of narcolepsy. http://www.uptodate.com/home/index.html. Accessed April 8, 2010.
- Scammel T. Treatment of narcolepsy. http://www.uptodate.com/home/index.html. Accessed April 8, 2010.
- Wise MS, et al. Treatment of narcolepsy and other hypersomnias of central origin. Sleep. 2007;30:1712.
- Narcolepsy. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/nar/nar_all.html. Accessed April 11, 2010.
- Morgenthaler TI, et al. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep. 2007;30:1705.
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