Cataplexy: Symptoms, Causes, and Treatment

Cataplexy vs. Narcolepsy: What’s the Difference?

Cataplexy is often associated with narcolepsy but they are not the same thing. Narcolepsy is a sleep disorder that causes excessive daytime sleepiness and sleep paralysis. Sufferers can also experience hallucinations and in some cases, cataplexy.

The Sleep Foundation explains that there are two major types of narcolepsy, including type 1 and type 2. Individuals with type 1 can experience episodes of cataplexy whereas individuals with type 2 don’t. The source points out that individuals with type 1 narcolepsy often start experiencing episodes of cataplexy after the onset of excessive sleepiness.

Symptoms of Cataplexy

According to Medical News Today, cataplectic attacks can vary from mild to severe. Some individuals may experience barely noticeable symptoms while others experience a full body collapse. The source says common symptoms of a cataplectic episode may include:

• drooping eyelids
• dropping the head or jaw
• jaw tremor
• facial twitching or grimacing
• speech difficulty
• abnormal tongue movements
• knee trembling

Attacks are usually short, lasting about a few seconds up to 2-minutes. After the attack, normal muscle function returns. However, if you notice anyone displaying these symptoms, it’s vital that you make sure they don’t hurt themselves if they collapse.

Cataplexy Triggers

Cataplectic attacks are usually triggered after you feel a strong emotion. According to Healthline, some emotional triggers may include:

• anger
• fear
• happiness
• laughter
• excitement
• stress

Unfortunately, triggers aren’t always consistent, meaning that laughing or anger may trigger an attack in one situation but not in another. Individuals with cataplexy also don’t have the same triggers — emotions that affect one person won’t always affect another.

Complications

A cataplectic attack can happen without warning. This can put your health at risk, especially if you’re driving a car or operating machinery. You can also be put in harm’s way if the attack occurs while you’re cooking, using knives, or using other sharp objects.

This is why it’s so important to get a proper diagnosis if you notice symptoms of cataplexy. After diagnosing the condition, your doctor can help you come up with a treatment plan and ways to help you manage your condition.

What Causes Cataplexy?

While we know that cataplectic attacks are triggered by emotions, what causes cataplexy to develop in the first place is unknown, explains Medical News Today. However, the source also notes that “a loss of neurons that produce hypocretin (also known as orexin) is thought to be a major contributing factor.” Hypocretin is a neurotransmitter that plays a role in wakefulness in the sleep/wake cycle.

Another theory suggests that individuals with cataplexy have a specific human leukocyte antigen, variations in T-cells receptors, or dysfunctional immune system responses to antigen exposures. Some theorize that narcolepsy is an autoimmune disorder but the source notes that more research is still needed.

Other Disorders Related to Cataplexy

While cataplexy is often associated with narcolepsy, the Sleep Foundation points out that “30% of cataplexy episodes are related to other disorders.” For starters, individuals with Niemann-Pick type C disease (NPC) may experience cataplexy along with cognitive impairment and dementia. NPC is a rare genetic disorder that causes an inability to transport lipids (like cholesterol) to cells, causing them to accumulate in body tissues. 

Other possible disorders linked to cataplexy include Prader-Willi syndrome, Angelman syndrome, strokes, brain tumors, and inflammatory processes. The source also notes that cataplexy may also be a side effect of some medications but this is usually very rare. Luckily, if this is the case, cataplexy usually goes away after stopping the medication.

Risk Factors

Narcolepsy isn’t an inherited disorder, however, Healthline explains about 10-percent of cases with narcolepsy and cataplexy have close relatives with symptoms of these conditions.

Other factors that may also increase your risk include having a traumatic head or brain injury. Tumors located near areas of your brain that control sleep may also increase your risk, as can infections like the H1N1 virus. Autoimmune conditions may also increase your risk for narcolepsy and cataplexy.

The source also notes that if you have narcolepsy, it is possible you’ll experience a cataplectic attack at some point. But keep in mind that not everyone with narcolepsy experiences cataplexy.

Diagnosing Cataplexy

Unfortunately, there isn’t a specific test to detect cataplexy which can make diagnosing the condition a challenge. The Sleep Foundation says cataplexy is usually diagnosed by interviewing the patient and their family.

During the interview, your doctor will be looking for signs of cataplexy while also asking about your episodes, including how long they last, what triggers them, and which muscles are affected during an attack. Your doctor will also ask about any current medications as well as your sleep routine and any other associated symptoms. If cataplexy or narcolepsy type 1 is suspected, your doctor may request an overnight and daytime sleep test.

How Is Cataplexy Treated?

Cataplexy cannot be cured but it can be managed. Healthline explains that both cataplexy and narcolepsy with cataplexy are typically treated with medication and lifestyle adjustments.

There are a variety of medications available but ultimately, your doctor will determine which one is best for you. As with all medications, there are potential side effects to be mindful of. Some possible side effects of these medications may include nervousness, changes in mood, and abnormal heartbeat. Ask your doctor about the potential side effects you can expect from the medication they prescribe.

Lifestyle Adjustments

Your doctor may also recommend lifestyle adjustments to help you manage the condition. Medical News Today says establishing healthy sleep hygiene habits is very important. These should include keeping to a consistent sleep schedule during the week, on weekends, and even when on vacation. You should also aim for 7- to 8-hours of sleep each night.

If you have trouble sleeping make sure your room is a comfortable and relaxing environment, avoid light exposure in the evening, and avoid caffeine late in the day. The source also notes maintaining a healthy diet, exercising regularly, avoiding alcohol, and taking one or more short naps throughout the day may help too.

Living With Cataplexy

Living with cataplexy can be a challenge, especially if you experience regular episodes. To help you cope, be sure to inform your close friends and family members about your condition. Explaining what it is, what symptoms to look for, and how it affects you can help them understand the condition as well as help you cope with it. It’s also important to inform your employer, especially if you need special accommodations.

Driving can be a serious risk so it may be best to let someone else drive you as much as possible. When engaging in activities always be aware of objects or terrain that may harm you. It’s also important to be prepared for situations that may cause strong emotions. Keep a chair close by or have a friend keep an eye on you in case you experience a cataplectic attack.

Finally, lean on support. Having cataplexy can be isolating and it can be emotionally draining. You can feel less alone by leaning on others for emotional and practical support.