Narcolepsy: 3 important things to know about cataplexy

Cataplexy is a symptom that affects some people with narcolepsy. It is characterized by sudden episodes of muscle weakness and muscle paralysis that occur while a person is awake. These episodes are typically short, lasting between a few seconds to a few minutes before resolving.

Narcolepsy is a neurological condition that disrupts the brain’s ability to regulate sleep-wake cycles. People with narcolepsy experience excessive daytime sleepiness (EDS), fragmented sleep at night, and sleep attacks, episodes where they are unable to stay awake and may fall asleep suddenly during waking hours. Other symptoms include sleep hallucinations and sleep paralysis.

Cataplexy is a different symptom than sleep attacks, and it does not result in a person falling asleep. However, EDS, sleep attacks, and cataplexy can all put a person’s safety at risk, and they can limit a person’s ability to drive and participate in many other activities. Narcolepsy symptoms often impact many areas of a person’s life, and lead to a lower quality of life. However, there are treatments that can help.

Below are three important things to know to better understand cataplexy.

Cataplexy is a symptom of narcolepsy type 1

Narcolepsy is categorized into two types, called narcolepsy type 1 and narcolepsy type 2. Cataplexy is a symptom of narcolepsy type 1, and narcolepsy type 1 is formerly known as narcolepsy with cataplexy. Narcolepsy type 2 does not involve cataplexy, but is the more common type of narcolepsy.

Episodes are often triggered by intense positive emotions

Episodes of cataplexy are triggered by intense emotions. These can be negative or positive emotions—things like stress, anger, and frustration, as well as excitement, surprise, or elation. While any intense emotion can trigger cataplexy, it’s more common for episodes to be triggered by positive emotions. Several studies have found that laughter is the most consistently identified trigger.

Cataplexy can be unpredictable and can vary from person to person. It can be helpful to keep a journal where you track episodes and the circumstances where cataplexy occurs.

Specific medications are prescribed to treat cataplexy

There is no therapy that can cure narcolepsy, and treatment focuses on managing and reducing symptoms. Medications are the main approach for treatment. It’s common for a person to take multiple medications—for example, a person may take one medication to help reduce excessive daytime sleepiness, and another medication to improve the quality of sleep.

People with cataplexy can be prescribed medications to help prevent episodes. Treatment for cataplexy typically begins with sodium oxybate medications. These medications are taken while in bed for the night to induce deep sleep and help regulate sleep cycles. These medications help reduce the frequency of cataplexy episodes and also help with EDS.

Though not specifically FDA approved to treat cataplexy, certain antidepressant medications may be prescribed off label to treat cataplexy. This may be done if treatment with sodium oxybate is not effective, but evidence about the effectiveness of this approach has been mixed.

Managing narcolepsy is different for everyone. For information about diagnosis and treatment, your best source of information will always be a healthcare provider.