Narcolepsy vs Sleep Apnea: Similarities & Differences Explained

Narcolepsy and sleep apnea are two sleep disorders that can greatly affect how well someone lives their life. Even though both affect sleep and significantly impact daily life and overall health, they have separate causes, symptoms, and treatments. Understand how narcolepsy and sleep apnea differ so that you can grasp these conditions better and know how they’re treated.

What is narcolepsy?

Narcolepsy is a neurological disease characterized by excessive daytime sleepiness (EDS) and a tendency to fall asleep unexpectedly and uncontrollably throughout the day. Narcolepsy affects about 1 in 2,000 people in the United States, impacting around 200,000 Americans and approximately 3 million people globally. People with narcolepsy frequently have interrupted evening sleep despite their excessive daytime sleepiness.

Symptoms of Narcolepsy

• Excessive Daytime Sleepiness (EDS): People with narcolepsy struggle to stay awake throughout the day, no matter how much sleep they get at night.
• Cataplexy: Strong emotions, such as laughter or surprise, can cause a sudden decrease in muscular tone.
• Sleep Paralysis: When you wake up or fall asleep, you may temporarily be unable to move or talk.
• Hallucinations: Intense dream-like experiences that occur while you fall asleep or awake.

Causes of Narcolepsy

Loss of a particular type of brain cell that produces hypocretin, a neurotransmitter that aids in regulating wakefulness and REM sleep, is the main cause of narcolepsy. This loss is often linked to autoimmune factors or genetic predispositions.

Treatment of Narcolepsy

Medications: Stimulants to promote wakefulness during the day and antidepressants to manage symptoms like cataplexy.
Lifestyle Adjustments: Scheduled naps and maintaining a regular sleep schedule can help manage symptoms.

What is sleep apnea?

On the other hand, sleep apnea is a breathing-related sleep disorder characterized by breathing disruptions while asleep. These disruptions, known as apneas, can happen several times during the night and last anything from a few seconds to minutes.

Sleep disorders, such as sleep apnea, are more common among U.S. adults than you might expect. According to the Centers for Disease Control and Prevention (CDC), three out of four U.S. adults exhibit symptoms of sleep disorders.

Types of Sleep Apnea

• Obstructive Sleep Apnea (OSA): The most common kind happens when the neck muscles relax.
• Central Sleep Apnea (CSA): Less commonly, the brain fails to deliver appropriate signals to the muscles that control breathing.
• Complex Sleep Apnea Syndrome (CompSA): Obstructive and central sleep apneas together.

Symptoms of Sleep Apnea

• Loud Snoring: Frequently the main symptom, particularly with obstructive sleep apnea.
• Daytime Fatigue: People with sleep apnea may wake up feeling unrefreshed and weary, even if they get enough sleep.
• Morning Headaches: Because of low oxygen levels during sleep.
• Breathing pauses: Observed by others, especially in obstructive sleep apnea.

Causes of Sleep Apnea

Usually, the relaxation of throat muscles results in airway obstruction and causes obstructive sleep apnea. Instability in the brain’s respiratory control center is what causes central sleep apnea.

Treatment of Sleep Apnea

• Continuous Positive Airway Pressure (CPAP): The most common therapy is to wear a mask that provides a constant flow of air to keep the airway open.
• Oral Appliances: Devices for keeping the throat open.
• Surgery: In serious instances where other therapies have failed, surgery may be used to remove tissue or rearrange the jaw.

What is the difference between narcolepsy and sleep apnea?

Narcolepsy and sleep apnea are distinct sleep disorders with significant differences in their causes, symptoms, and effects on sleep patterns:

Causes:

• Narcolepsy: Caused by a loss of brain cells that produce hypocretin, a neurotransmitter that regulates wakefulness and REM sleep.
• Sleep Apnea: Generally caused by relaxation of throat muscles leading to airway obstruction (obstructive sleep apnea) or by a lack of brain signals to control breathing (central sleep apnea).

Symptoms:

• Narcolepsy: Having a lot of daytime sleepiness, rapid muscle loss (cataplexy), sleep paralysis, and vivid hallucinations are all signs of this disorder.
• Sleep Apnea: Symptoms include loud snoring, repeated pauses in breathing during sleep, gasping or choking sensations, morning headaches, and daytime fatigue.

Impact on Sleep:

• Narcolepsy: Disrupts the normal sleep-wake cycle, causing sudden sleep episodes during the day and fragmented nighttime sleep.
• Sleep Apnea: Results in fragmented sleep due to repeated interruptions in breathing, leading to poor sleep quality and excessive daytime sleepiness.

Treatment:

• Narcolepsy: Medications were used to keep people awake (stimulants) and to control symptoms like cataplexy (antidepressants). Changes to your lifestyle, like planning naps, may also be suggested.
• Sleep Apnea: Frequently treated with continuous positive airway pressure (CPAP) therapy, which entails wearing a mask that delivers air pressure to keep the airway open while sleeping. Other treatments include oral appliances and, in severe cases, surgery.

Understanding these differences is crucial for accurate diagnosis and effective management of these sleep disorders, as they require tailored approaches to improve sleep quality and overall well-being.

How are sleep apnea and narcolepsy similar?

While narcolepsy and sleep apnea are distinct sleep disorders with significant differences, they also share some similarities:

• Impact on Daily Life: Both conditions can lead to excessive daytime sleepiness, impairing daily activities such as work, driving, and social interactions.
• Sleep Disruption: Both narcolepsy and sleep apnea disrupt normal sleep patterns. Narcolepsy can cause fragmented nighttime sleep along with excessive daytime sleepiness, while sleep apnea results in frequent interruptions in breathing that disrupt sleep quality.
• Medical Management: Both disorders often require management intervention. Narcolepsy may be treated with medications to promote wakefulness and manage symptoms like cataplexy, while sleep apnea is commonly managed with continuous positive airway pressure (CPAP) therapy or other interventions to keep the airway open during sleep.
• Health Risks: If left untreated, both narcolepsy and sleep apnea can pose substantial health hazards. Narcolepsy increases the risk of accidents due to sudden sleep episodes, while sleep apnea is associated with cardiovascular problems and daytime fatigue.
• Diagnostic Challenges: Both disorders can be challenging to diagnose accurately and may require specialized sleep studies or evaluations by sleep specialists to differentiate them from other sleep disorders or conditions.

Recognizing these similarities can help understand the shared impact of these disorders on sleep and overall health despite their distinct underlying causes and specific symptoms.

Can sleep apnea cause narcolepsy?

While sleep apnea and narcolepsy are different conditions, there is evidence suggesting that sleep apnea might cause similar symptoms to narcolepsy in some people. This is often referred to as “secondary narcolepsy” or “sleep apnea-related daytime sleepiness.”

In cases of secondary narcolepsy, the ongoing lack of quality sleep and reduced oxygen levels linked with sleep apnea can result in excessive daytime sleepiness and other symptoms similar to narcolepsy. However, these symptoms usually improve once sleep apnea is effectively managed with CPAP therapy or other treatments.

It’s crucial to realize that secondary narcolepsy is uncommon and that the majority of cases of narcolepsy are primary, meaning they are not the result of another underlying condition.

How do doctors diagnose narcolepsy and sleep apnea?

Both conditions are typically identified through a mix of medical history, physical exams, and sleep tests. Here’s a simple look at how each one is diagnosed:

Narcolepsy diagnosis

A sleep expert may request a polysomnogram (sleep study) to watch brain waves, eye movements, and muscle activity during sleep. They may also do a multiple sleep latency test (MSLT) to determine how quickly a person falls asleep during the day.

Sleep apnea diagnosis

A sleep specialist may order a polysomnogram to observe breathing patterns and oxygen levels while sleeping. They could also suggest a home sleep apnea test, which uses a portable device to monitor breathing at home.

In some situations, extra tests may be needed to rule out other issues or determine how severe the sleep problem is.

Narcolepsy is Different From Sleep Apnea

Narcolepsy and sleep apnea are unique sleep disorders that significantly affect daily life and health. Regardless of their causes, symptoms, or therapies, recognizing these disorders is critical for optimal management. Narcolepsy causes daytime sleepiness, sudden muscle weakness, sleep paralysis, and hallucinations due to a lack of certain brain cells. Treatment involves stimulants and lifestyle changes. Sleep apnea, characterized by breathing pauses during sleep, is managed with CPAP therapy or surgery to keep the airways open. Both disorders disrupt sleep and require personalized care to improve overall well-being.