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Narcolepsy - Daytime sleepiness

From MayoClinic.com

Screening and diagnosis

Your doctor may make a preliminary diagnosis of narcolepsy based on your experience of both excessive daytime sleepiness and sudden loss of muscle tone (cataplexy). After an initial diagnosis, your doctor may refer you to a sleep specialist for additional studies and evaluation.

Formal diagnosis may require staying overnight at a sleep center where you undergo an in-depth analysis of your sleep by a team of specialists. Methods of diagnosing narcolepsy and determining its severity include:

• Sleep questionnaire. The Epworth Sleepiness Scale uses a series of short questions to diagnose narcolepsy. You'll be asked to rank on a numbered scale whether certain situations, such as sitting down after lunch, make you sleepy and, if so, how sleepy.

• Polysomnogram. This test involves a variety of measuring tactics conducted through electrodes placed on your scalp before you fall asleep. For this test, you must stay overnight for observation at a medical facility. The test measures the electrical activity of your brain (electroencephalogram) and heart (electrocardiogram), and the movement of your muscles (electromyogram) and eyes (electro-oculogram).

• Multiple sleep latency test. This method measures how long it takes for you to fall asleep during the day. You'll be asked to fall asleep for a series of four or five naps, each nap two hours apart. Specialists will observe your sleep patterns. People who have narcolepsy fall asleep easily and enter into rapid eye movement (REM) sleep quickly.

These tests also can help doctors rule out other possible causes of your signs and symptoms. Other sleep disorders, such as sleep apnea, can cause excessive daytime sleepiness.

Narcolepsy may cause you to experience serious problems in both your professional and personal lives. Others may perceive your undiagnosed condition as lazy, lethargic or rude. Your performance may suffer at school or work.

Narcolepsy often affects intimate relationships. Extreme sleepiness may cause low sex drive or impotence, and people with narcolepsy may even fall asleep while making love. The problems caused by sexual dysfunction may be further complicated by emotional difficulties. Intense feelings, such as anger or joy, can trigger some signs of narcolepsy, causing affected people to withdraw from emotional interactions.

Sleep attacks may result in physical harm to people with narcolepsy. You're at increased risk of a car accident if you have an attack while driving. Your risk of cuts and burns is higher if you fall asleep while preparing food.

• Chronic fatigue syndrome (CFS)
• Fatigue
• Impotence
• Multiple Chemical Sensitivity or MCS 
• Sleep apnea

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