Narcolepsy often goes undiagnosed for a decade or more after symptoms first appear. This is because narcolepsy’s early symptoms may be subtle. When the symptoms develop, people might not recognize they have a disorder of the central nervous system and therefore don’t know to seek diagnosis and treatment.
Excessive daytime sleepiness (EDS) is narcolepsy’s primary symptom. The polysomnogram and multiple sleep latency test are key to determining if EDS is caused by narcolepsy or other reasons, such as an underlying medical condition, sleep deprivation, or medication
- Polysomnogram. This overnight test continuously measures bodily functions such as heart rate, respiration, eye movements, blood pressure, blood oxygen levels, electrical activity in the brain and movement in the muscles. A polysomnogram sheds light on whether the rapid eye movement (REM) stage of sleep takes place at abnormal times in the sleep cycle or if sleep disrupting conditions such as sleep apnea are present. This information then helps determine if the excessive daytime sleepiness is due to narcolepsy or something else.
- Multiple sleep latency test. This study occurs during the day, often following an overnight sleep study. The goal is to measure how long it takes to fall asleep and whether the REM stage of sleep occurs at abnormal times. Small electrodes are placed on various areas of your body to record brain waves, eye movements, heart and respiratory rates and chin muscle tone. During the test, you will take several timed naps every two hours throughout the day.
Besides sleep tests, you may be asked to fill out extensive and specialized questionnaires and keep sleep logs or sleep diaries for two or three weeks. Testing spinal fluid for levels of hypocretin, a brain chemical that is low in those with narcolepsy, may be useful test in the for some patients.