Any condition that leaves you unable to move, even for a short amount of time, can be scary. However, many people live with the risk of this every day, in the form of either cataplexy or narcolepsy. We will try to answer the question, “What is cataplexy?” and look at what this condition means and how it can be managed for a better quality of life.

What Is Cataplexy?

Sleep specialists define cataplexy as a sudden but brief loss of muscle control usually triggered by strong emotions. These emotions are usually considered positive, such as a fit of laughter. 

Sometimes the episode can cause someone to fall and be completely paralyzed for a couple of minutes, although they can usually still move their eyes. In other instances, only partial paralysis occurs, which may be seen in the barest droop of an eyelid.

Some people assume that cataplexy is a symptom associated with narcolepsy; however, by definition, cataplexy is a condition in its own right, rather than simply a symptom. Cataplexy can also occur due to:

• Angelman Syndrome
• Norrie Disease
• Medication such as lamotrigine or clozapine

For a narcolepsy definition, Psychology Dictionary states that it is a “neural disorder which consists of excessive daytime sleepiness which is paired with very brief attacks of sleep which cannot be repressed during the waking hours.” In other words, sufferers of severe narcolepsy may fall asleep without warning at any point.

Cataplexy is found in many sufferers of narcolepsy, although it may not exhibit until years after the onset of narcolepsy or excessive daytime sleepiness (EDS). Narcolepsy sufferers who also experience cataplexy are often described as having Type 1 narcolepsy.

Narcolepsy vs. Cataplexy

• During an episode of narcolepsy, the individual is asleep, but during cataplexy, they are awake and unable to move.
• Narcolepsy isn’t usually affected by how much sleep the individual gets per night, whereas it’s possible cataplexy may be managed via a good sleep routine.
• Cataplexy can occur even if you don’t have narcolepsy but is often misdiagnosed as some sort of seizure disorder.
• Cataplexy is associated with strong emotion, whereas narcolepsy doesn’t always have a specific trigger.

Causes of Cataplexy

Both narcolepsy and cataplexy may be associated with a lack of the neurotransmitter hypocretin. This could be due to an overactive immune response in the brain. People who experience cataplexy may experience one episode a year or multiple episodes every day. It’s not known for certain what governs the frequency or strength of the episodes. 

Cataplexy may also be worsened by fatigue, sudden changes in medication, and even stress. Some people state that stressful situations can be a direct trigger for an episode. 

Symptoms of Cataplexy

Because the severity of cataplexy episodes varies, it can be helpful to understand how it presents. It may be a full paralysis event, but it could also be:

• Facial twitches
• Flickering eyes or an involuntary grimace
• Sudden difficulties with a speech that resolve after a couple of minutes
• Drooping eyelids
• Knees trembling
• Suddenly dropping the head or jaw

These symptoms can be alarming to anyone who is not aware that they suffer from cataplexy, as some of these symptoms resemble what happens when you have a stroke. If in any doubt at all, seek emergency medical care.

You should also contact your doctor if you experience any of these symptoms, particularly if you suffer from narcolepsy or EDS, as they may be able to prescribe treatment or give advice.

Dangers of Cataplexy

Cataplexy doesn’t have any known physical ramifications other than the risk of hurting yourself if you fall. There’s no lasting damage to either the brain or the body after an episode. However, if your muscles fail while you are out and about, of course, there is the risk of injuring yourself.

Make sure whoever you are out with knows that you could have an episode and wear clothes that you’re less likely to get injured in, for example, jeans rather than shorts. At home, consider soft carpets instead of hard floors, and try to ensure that glass and other breakables are out of the way of anywhere you may fall.

Treatment for Narcolepsy and Cataplexy

Neither narcolepsy nor cataplexy has a cure, but there are ways to manage symptoms or minimize the likelihood of experiencing an episode of either condition. 

Medication

Currently, sodium oxybate is prescribed for some individuals who experience cataplexy or narcolepsy. It may reduce the intensity and the frequency of episodes, but side effects can include nausea and headaches, so discuss this with your doctor.

Good Sleep Hygiene

There’s no evidence showing that improving sleep disorders at night affects narcolepsy. But it could reduce the intensity of cataplexy episodes.

• Try to go to sleep at the same time every night.
• Try to rise at the same time each day.
• Regular napping may be recommended for narcoleptic people who are excessively sleepy in the daytime.
• Only eat lightly before bedtime.
• Keep your sleeping space at a good temperature, quiet, and dark.
• Avoid technology for an hour before going to bed.

Lifestyle Management

You may be able to reduce the intensity of episodes by:

• Limiting alcohol
• Limiting caffeine
• Eating a healthy, balanced diet
• Exercising regularly
• Maintaining good mental health and talking to someone if needed

It’s helpful to know that you’re not the only one experiencing these episodes. Ask your doctor if there is a support group or search for one in your local area. You may even find people who have dealt with cataplexy who can give you their coping strategies and help you take back control of your days.

Takeaway

Cataplexy is a sudden loss of muscle control often caused by strong emotion, such as laughter. It can be associated with narcolepsy. Good sleep hygiene and routines might be effective in minimizing the impact of cataplexy and narcolepsy.