No matter how much they sleep, they always seem to be sleepy. It’s a child who gets off the school bus and immediately takes a 3-hour nap before getting up, doing some homework, and going right back to sleep again and sleeps 13 hours on the weekends. That’s an individual who seems to be exhibiting a much stronger drive to sleep than normal. The cardinal feature, the feature that’s there 100% of the time, is something we refer to as excessive daytime sleepiness, sometimes abbreviated EDS. The signs and symptoms of narcolepsy are all at once easy to see and very difficult to see. But really type 1 and type 2 probably refers to the presence or absence of that chemical orexin, but since we don’t typically test for it because it involves a spinal tap, we usually differentiate type 1 and type 2 by the presence of cataplexy. Usually, we describe narcolepsy type 1 as people who have that symptom, cataplexy, and type 2 people who do not. Cataplexy is just a loss of muscle tone that can either be profound or actually quite subtle when somebody has some sort of emotion, either laughter or being upset. That’s when you’re walking down the street and suddenly you fall over asleep, which is not entirely what cataplexy is. Narcolepsy is characterized as either type 1 or type 2, usually by the presence of a symptom called cataplexy, which is what a lot of people think about when they think about narcolepsy. When we don’t have that chemical or it’s not present in sufficient quantities, no matter how much we sleep, we still have a drive often to sleep throughout the day. The purpose of that chemical is to actually stabilize wakefulness in our brain. It was given 2 different names by 2 different laboratories.
It is caused by the lack of or insufficiency of a chemical in our brain called either orexin or hypocretin. I would say fundamentally narcolepsy is a condition of excessive daytime sleepiness. Chris Winter, MD:Narcolepsy is a condition that is characterized mainly by an individual who has an overwhelming or an excessive drive to sleep.
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