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Things Narcolepsy May Look Like but Isn’t

Medically Reviewed by Neha Pathak, MD on June 30, 2021

Narcolepsy is a sleep disorder that affects your brain’s control over your sleep-wake cycles. If you have it, you may wake up many times during the night and have uncontrollable urges to sleep throughout the day. Narcolepsy isn’t common, and its symptoms mimic those of many other health issues. That’s why it can be easy for doctors to mistake it for something else. As many as 60% of people with narcolepsy get a diagnosis of something else at first.

Doctors sometimes mistake narcolepsy for conditions like:

Insomnia. It’s common to have trouble sleeping when you have narcolepsy. You may wake up many times during the night. You can also have trouble falling asleep. This could lead you and your doctor to think you’re sleep-deprived and have insomnia.

Obstructive sleep apnea. Feeling very drowsy during the day is a symptom of both narcolepsy and obstructive sleep apnea. The latter causes your throat muscles to block your airway while you sleep. Many people with narcolepsy also have sleep apnea. If doctors find your sleep apnea first, they may not keep looking for other issues. As a result, it may take some time before you get a narcolepsy diagnosis.

Depression. Many signs of depression and narcolepsy look alike. Among some of the most common are trouble sleeping, fatigue, weight gain, and lack of focus. Because narcolepsy reduces your quality of sleep, which can impact mental health, it may also cause depression.

Anxiety. Over half of people who have narcolepsy also have an anxiety disorder like panic attacks or social anxiety. You could also become anxious as a response to the hallucinations (seeing or hearing things that aren’t there) or cataplexy (sudden muscle weakness) that narcolepsy can cause.

Schizophrenia. Both schizophrenia and narcolepsy can cause poor sleep and hallucinations. One difference is that if you have narcolepsy, you’re more likely to see things that don’t exist just before you fall asleep or right after you wake up. On the other hand, schizophrenia often causes you to hear things that aren’t real.

Epilepsy. Cataplexy can weaken one area of your body, slur your speech, or make you unable to move for a short time. These symptoms look a lot like a seizure and may lead to a diagnosis of epilepsy. This could lead to the wrong treatment and keep you from getting help for your narcolepsy for several years.

Chronic fatigue syndrome. Some narcolepsy symptoms, like extreme daytime sleepiness, trouble sleeping at night, and an ongoing lack of energy, overlap with chronic fatigue syndrome (CFS). Many people with CFS also have narcolepsy.

ADHD (attention deficit hyperactivity disorder). Poor-quality sleep can cause brain fog and trouble with focus, which may look like ADHD. Feeling hyper (finding it hard to sit still) can also mislead doctors. Although it’s a well-known symptom of ADHD, hyperactivity can also be your body’s response to feeling sleepy and trying to wake up.

If you think you have narcolepsy, talk to your primary care doctor or a sleep doctor about your symptoms. They can rule out other health issues and order sleep tests that can confirm narcolepsy. While there’s no cure for narcolepsy, treatments and lifestyle changes can help you manage it.

Show Sources

SOURCES:

National Institute of Neurological Disorders and Stroke: “Narcolepsy Fact Sheet.”

Sleep & Breathing: “Misdiagnosis of Narcolepsy.”

Pulmonology Advisor: “Narcolepsy.”

Sleep Medicine: “Obstructive Sleep Apnea in Narcolepsy.”

National Alliance on Mental illness Cook County North Suburb: “Narcolepsy: the Most Underrated Mental Health Killer.”

Medical Sciences: “Narcolepsy and Psychiatric Disorders: Comorbidities or Shared Pathophysiology?”

Innovations in Clinical Neuroscience: “Narcolepsy Presenting as Schizophrenia: A Literature Review and Two Case Reports.”

Journal of the Neurological Sciences: “Narcolepsy type 1 clinical symptoms misdiagnosed for epileptic seizures.”

Neurologia: Chronic fatigue syndrome and sleep disorders: Clinical associations and diagnostic difficulties.

American Thoracic Society: “What is Narcolepsy?”

Mayo Clinic: “Narcolepsy.”

American Academy of Sleep Medicine: “Narcolepsy.”

Neurology Reviews: “A Patient’s Path to Narcolepsy Diagnosis is Frequently a Long and Winding Road.”

National Sleep Foundation: “Do I Have Narcolepsy?”

Mount Sinai: “Narcolepsy.”

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