Narcolepsy in Children: Symtpoms and Misdiagnosis

Narcolepsy is often not recognized in children and may not be diagnosed until adulthood. Symptoms can mimic other disorders delaying diagnosis. What are some symptoms and misdiagnoses of narcolepsy in children?

Narcolepsy is a sleep disorder that can begin in childhood. It is characterized by abnormal rapid eye movement (REM) sleep patterns that can come about during waking hours.

Since symptoms can appear gradually over time or mimic other conditions, many who suffer narcolepsy aren't accurately diagnosed until adulthood. This makes narcolepsy seem rare in children as most pre-adult diagnoses occur in teen years.

Excessive daytime sleepiness. Excessive daytime sleepiness is the most common and obvious symptom of narcolepsy in children and adults. This can make it hard for kids to concentrate or stay focused which can lead to a possible misdiagnosis of ADHD. Irritability from lack of sleep can be misdiagnosed as a mood disorder. Being extremely overtired can also cause an uncontrollable urge to sleep and falling asleep suddenly. Excessive daytime sleepiness can also be caused by obstructive sleep apnea. Even if sleep apnea is diagnosed, narcolepsy shouldn't be ruled out as both sleep disorders can occur together.

Cataplexy. A loss of muscle control called cataplexy is another common symptom of narcolepsy. This can be as slight as a feeling of weakness in the knees or may cause the child to drop what they are holding. But it can be as severe as to cause a loss of muscle control over the entire body causing the child to collapse. This often happens during periods of high emotion, even laughter. Cataplexy can cause narcolepsy to be misdiagnosed as epilepsy or other seizure disorders or other neurological problems.

Sleep Paralysis. Sleep paralysis is a temporary paralysis that happens during the sleep-awakening transitions of either falling asleep or waking up. This can last up to a few minutes and the child feels completely awake. It is believed that sleep paralysis occurs when someone wakes up before brain signals reach the muscles to allow for movement and appears to be related to abnormal REM sleep patterns. Sleep paralysis may be misdiagnosed as a symptom of any medicines your child is taking rather than narcolepsy.

Hallucinations. Vivid, dreamlike hallucinations can occur during sleep-awakening transitions as well, with or without sleep paralysis. A child can believe these hallucinations to be real by seemingly real sensory perceptions such as smell and touch. These hallucinations are often frightening and nature. Because of the perception of reality, hallucinations as a symptom of narcolepsy are often misdiagnosed as a psychiatric illness.

Other Symptoms. Other symptoms of narcolepsy include wakening up frequently at night and automatic behaviors, where children actually can perform tasks with knowing or even remembering that they did them.

Narcolepsy in Children. Narcolepsy may be more common in children than previously recognized due to the possible slow onset of symptoms and risk for misdiagnosis. If you suspect your child has narcolepsy or shows any symptoms of a sleep disorder or other illness, please see your child's doctor for a proper diagnosis.

THIS ARTICLE IS FOR INFORMATIONAL PURPOSES ONLY AND IS NOT INTENDED TO DIAGNOSE OR TREAT ANY ILLNESS.

SOURCES:

National Heart Lung and Blood Institute; What Are Signs and Symptoms of Narcolepsy?

eMedTV; Narcolepsy in Children