07/09/2010 08:29 am ET | Updated Nov 17, 2011

Narcolepsy: An Autoimmune Disorder?

You might love your sleep -- and your naps -- but probably not enough to want narcolepsy, one of the more difficult sleep disorders to manage. What few people realize, though, is that narcolepsy isn't just about falling asleep frequently during the day at inopportune times. About three-quarters of narcoleptics are at the mercy of emotional reactions that trigger their body to physically experience muscle paralysis. So imagine being happily excited or, conversely, suddenly frightened, and all of the sudden your body freezes against your will and you can't move.

And imagine this heartbreaking, agonizing disorder coming uncontrollably from within you. From your own immune system.

It's long been thought that narcolepsy is an autoimmune disorder whereby an individual's immune system goes haywire; rather than targeting just foreign invaders and germs, it instead turns against the body and begins attacking certain cells. Although this has never been definitively proven, we now have more evidence showing that narcolepsy indeed may be blamed on a misfiring immune system.

Researchers at the University of Lausanne, Switzerland, have now identified auto-antibodies (immune molecules that target a natural protein in the body rather than a protein from an infectious agent) that target a natural protein called Trib2 in narcolepsy patients who experience paralysis linked to their emotions. This clearly suggests that narcolepsy could be an autoimmune disorder. Normally, the immune system can distinguish between "self" and "not self" and only attacks those tissues that it recognizes as foreign, or "not self."  But when it comes to narcolepsy, it seems we could have a mutiny on our hands.

And the fact that it's an autoimmune disorder makes it all the more challenging to treat and attempt to cure. What are the signs of narcolepsy?

  • Excessive daytime sleepiness is typically the first symptom of narcolepsy. It's the overwhelming need to sleep when you prefer to be awake.
  • Narcolepsy is typically associated with a sudden weakness or paralysis often initiated by laughter or other intense feelings, sleep paralysis -- an often frightening situation where you are half awake yet cannot move -- and intensely vivid and scary dreams occurring at the onset or end of sleep.
  • A narcoleptic may also experience "automatic behavior," in which you perform routine or boring tasks but can't remember doing so later.

The cure? There isn't one yet. For people with narcolepsy, naps are especially important. A nap can actually replace a dosage of a stimulant medication. Autoimmune disorders in general are difficult to cure. Other illnesses that are also considered autoimmune disorders include type-1 diabetes, rheumatoid arthritis, lupus and multiple sclerosis.

The good news from this latest study is that it gives us a little more insight into this strange and perplexing disorder. What's more, if we can confirm narcolepsy as an autoimmune disorder, then we can examine it as such to eventually find a cure, or perhaps identify a better way to treat and manage the disorder.

For more information about narcolepsy, visit The Narcolepsy Network.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

This post on narcolepsy is also available at Dr. Breus's official blog, The Insomnia Blog by Sleep Doctor Michael Breus, PhD.