The Difficulties in Diagnosing Narcolepsy

Many symptoms of Narcolepsy mimic the symptoms of other common medical disorders, especially sleep disorders. Symptoms like daytime sleepiness and moodiness are common, and often go untreated because they are unrecognized. Many patients who experience the problems do not seek medical treatment; they brush the problem under the rug making diagnosing Narcolepsy very difficult. Many medical professionals also misdiagnose Narcolepsy with other sleeping disorders, depression, and even epilepsy. Because Cataplexy is the only symptom really unique to Narcolepsy, it is often its only identifier.

If a medical professional diagnoses you with Narcolepsy, or other common sleeping disorders, they are likely to refer you to a sleep specialist for further testing. Sleep clinics and sleep labs are equipped with the facilities and technology needed to evaluate the specific constrictions that accompany your individual Narcolepsy case. Sleep tests are also recommended to many patients who experience symptoms of other sleeping disorders; they can are a great tool for separating the identifying symptoms of many different disorders.

Narcolepsy Testing

Not all hospitals are equipped with sleep labs, so you may have to do a little hunting. Many universities have medical campuses that house the necessary facilities. If the university closest to you does not have a sleep clinic, they should be able to point you in the right direction. Choosing a sleep lab for your Narcolepsy testing should be a delicate, well-researched venture. Choose your sleep specialist like you would you psychiatrist; it must be someone that you can trust and are comfortable with because you will be sharing a lot of personal information.


The most commonly administered Narcolepsy test used to diagnose and understand the sleeping disorder is the polysomnogram. The polysomnogram is a rather routine test and is also used to test patients with other sleep disorders like Sleep Apnea and Parasomnia. The polysomnogram is an overnight sleep study; the patient sleeps at the facility under the care and supervision of a trained medical professional.

The patient is attached to machine through electrodes and wires. The electrodes are placed on various parts of the sleeper’s body are able to pick up electrical energy from the sleeper and send the information to a machine where the activity is analyzed and interpreted into data that the test administrator records. Brain activity, eye movement, heart rhythm, breathing patterns, oxygen level changes, and even physical movements of the body can all be interpreted and recorded during sleep through a polysomnogram. Because patients with Narcolepsy enter the REM stage of sleep almost immediately upon falling asleep, the polysomnogram is a useful tool for identifying this symptom.

Multiple Sleep Latency Test

Second to the polysomnogram, the Multiple Sleep Latency test is the second most common of all Narcolepsy tests for patients who are experiencing symptoms and signs of the debilitating disorder. This test, also performed in a sleep lab under medical guidance, is used to measure the amount of time that lapses between attempting to fall asleep and actually falling asleep; Multiple Sleep Latency Testing can identify the first physical changes in the body that occur when actual sleep takes place. Like the polysomnogram, this test is often used to diagnose an array of other sleeping disorders, but the MSLT is especially effective at measured the effectiveness of current treatment methods in previously diagnosed patients.

In most cases, Multiple Sleep Latency Tests are performed the day following a polysomnogram test. Performing the test the following day allows you sleep professional to gain a more complete and accurate understanding of your unique symptoms and habits. The test is many hours long, and within this period of time, the patient is given periodic segments of twenty minutes in which he is prompted to nap. If they fall asleep, they are awakened after twenty minutes by the test administrator; if they fall asleep during their scheduled waking time, the test administrator will also wake them. The different changes and reactions that take place in the body upon falling asleep and awakening are recorded for further analysis.

Maintenance of Wakefulness Test

The third most common form of sleep testing used to identify the symptoms of Narcolepsy is the Maintenance of Wakefulness Test. Like the name of the test suggests, this sleep study is used to record a patient’s ability to stay awake. Narcoleptic patients are able to use this test specifically to identify the severity of their sleep attacks, and whether or not they could be a danger to themselves or others. The Maintenance of Wakefulness Test is similar to the Multiple Sleep Latency test in that it is usually administered the day after a polysomnogram and is many hours long.

During the test, the patient is asked to try their best to maintain wakefulness; this way, the administrators are able to tell how well her body is able to stay awake naturally and without any outside influences that might alter the results. If and when a patient falls asleep, the test administrator will wake them up after ninety seconds. The test consists of periodic sessions throughout the day, and if the sleeper does not fall asleep within the first forty minutes of each session, the session will discontinue.

The Maintenance of Wakefulness Test is pretty boring. In most cases, the test is performed in a modest, quiet room that is commonly set up to look something like a hotel room. The test will probably commence a few hours after waking up from the polysomnogram. There are no sounds or distractions in the room; it is meant to be free of any outside influences that may disrupt the patient’s natural ability to stay awake. The patient is placed in a bed sitting upright comfortably (most facilities will offer pillows for the patient’s comfort).

Hypocretin Test

Some Narcolepsy patients, or prospective Narcolepsy patients, are recommended for Hypocretin testing. The fluid that encompasses the spinal cord is called Hypocretin, and testing the levels of Hypocretin around the spinal cord can help doctor’s diagnose Narcolepsy in more difficult cases.

Hypocretin testing takes place through a spinal tap. During a spinal tap, the doctor inserts a needle into the lower back of the patient. The needle reaches the Hypocretin around the spinal cord and is able to retain some of the fluid found there. The fluid is extracted and used for Hypocretin level testing. It is an uncomfortable procedure, and is usually a last resort for patients who may be suffering from Narcolepsy.


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