Narcolepsy in Children: Symptoms, Causes, and Treatment

Narcolepsy in children can be difficult to spot, but persistent excessive daytime sleepiness is a key symptom. Treatments can help both adults and children.

Narcolepsy is a chronic neurological disorder that affects your brain’s control of sleep and wake cycles.

It’s a rare condition that affects 1 in 2,000 people. Symptoms usually start in childhood, but a diagnosis is usually not confirmed until later in adolescence or early adulthood.

Children with narcolepsy experience extreme daytime sleepiness and difficulties staying awake. This impacts relationships with peers and family and school performance.

A sleep specialist can provide a diagnosis and treatment options to address and manage the child’s narcolepsy.

Narcolepsy is a chronic sleep disorder that causes consistent and difficult-to-control sleepiness.

The condition causes people to feel tired throughout the day. Narcolepsy also causes people to fall asleep suddenly, no matter the day or activity.

Narcolepsy symptoms often present between ages 7 to 25. But symptoms can occur at any point in life.

The most common symptoms of narcolepsy in children are:

  • excessive daytime sleepiness
  • sudden sleep episodes
  • cataplexy — loss of voluntary muscle control
  • Scary, vivid, and or dreamlike hallucinations, both visual or auditory, when falling asleep

It can be difficult to see the condition in your child because they may not know how to discuss symptoms. Or you may think they’re not getting enough sleep and just need more rest.

These sleep disruptions affect your child’s work in school or ability to enjoy social activities. If you think your child’s excessive need for sleep is getting in the way of their life, talking with a primary care doctor is essential.

Differences between narcolepsy in children and in adults

Narcolepsy symptoms can look different in children than in adults.

“Pediatric cataplexy symptoms may include subtle and unusual facial expressions or choreic-like movements, which are not observed in adults,” according to 2018 research.

The research also noted that children Might show slurred speech or display various movements, such as scratching or facial movements. Children with narcolepsy also sometimes display the following behaviors because of sleepiness:

  • irritability
  • difficulty with concentration and attention
  • other hyperactive behaviors

Pediatric narcolepsy may also be associated with:

If your child shows signs of excessive sleepiness or suddenly falling asleep, seeking care from a medical professional is essential.

Untreated narcolepsy in your child can disrupt many aspects of their life and result in notable stress for them. Still, treatment is possible.

Narcolepsy is a rare disorder. The exact cause remains unknown.

However, recent research says people with narcolepsy have low levels of hypocretin, a brain chemical that controls sleep and wakefulness.

Other possible factors that can play a role in narcolepsy include:

  • family history
  • brain injury
  • genetic factors
  • environmental factors
  • an autoimmune disorder
  • infections

Narcolepsy could have many causes — even combinations of multiple causes. Still, research explores other possible factors that might contribute to narcolepsy.

Narcolepsy is often underdiagnosed or misdiagnosed in children.

Often, clinicians may mistake narcolepsy symptoms for other psychiatric or neurological conditions. Some studies report that it can take 8 to 10 years for children to become diagnosed correctly with narcolepsy.

Your child’s medical doctor can address any concerns about your child’s sleep or possible narcolepsy. Though it’s not statistically likely your child will have narcolepsy, knowing the symptoms will help you advocate for your child they are examined for a sleep disorder.

The symptoms of narcolepsy often appear in childhood, adolescence, or young adulthood, typically between the ages of 7 and 25.

Two standard tests performed in a sleep disorder clinic are required to establish a narcolepsy diagnosis:

  • Polysomnogram (PSG), an overnight recording of the child’s breathing and activity in the brain and muscles. This test measures the sleep cycle and can rule out other conditions, such as sleep apnea.
  • Multiple sleep latency test (MSLT). A daytime test to measure how quickly a child falls asleep and enters REM sleep.

In addition to these sleep tests, getting an accurate narcolepsy diagnosis requires a patient’s detailed medical history. Also, a medical professional performs a physical examination on your child to rule out any other conditions that may be causing the symptoms.

While there is no current cure for narcolepsy, there are pediatric narcolepsy treatments that can help reduce sleepiness and improve alertness so children can manage their symptoms and learn to live with the condition.

According to the National Institute of Neurological Disorders and Stroke (NINDS)the most common treatment options for adults and children are medications and lifestyle changes.

Suggested behavior modifications are developing healthy habits such as:

  • Maintaining a regular sleep/wake schedule
  • keep your bedroom quiet, dark, cool, and comfortable
  • Avoid watching TV or bringing computers or phones into bed with you
  • avoid caffeine for several hours before bedtime
  • taking short naps
  • exercising daily
  • relaxing before bedtime
  • avoiding heavy meals before bedtime

In addition, many choose to pursue medication as part of a treatment plan. Stimulants may help children stay awake during the day. Antidepressants can help treat disrupted sleep, cataplexy, hallucinations, and sleep paralysis.

Educating other people about their diagnosis in your child’s life is also helpful.

Kids may find it helpful to talk about their symptoms with others going through the same experience.

Also, a support group can help manage symptoms. Being around others who understand what it’s like to live with narcolepsy is helpful.

You can find an online support group by visiting the following:

Despite the hardships of the disorder, children with narcolepsy can live a full and rewarding life.

If your child has trouble staying awake or you suspect your child has narcolepsy, a neurological sleep disorder characterized by excessive daytime sleepiness, there are treatment options.

Medications and behavior modifications can help manage symptoms, while a support group can offer emotional support.

Narcolepsy is a challenging but manageable condition.

Having pediatric narcolepsy can be discouraging for your child. But treatment can provide significant relief.

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