Sleep Architecture

Sleep experts can monitor brain wave activity during sleep to map how sleep patterns are structured and organized. This is called your sleep architecture.² People with narcolepsy often have disruptions in their sleep architecture.³

“A well-balanced sleep architecture ensures that you spend enough time in each stage of sleep, allowing you to wake up feeling refreshed and ready for the day,” Dr. Ortiz said.⁴ “When this balance is disrupted, it can be like an orchestra out of tune, affecting how well you function during the day.”

Fragmented Sleep

People with narcolepsy often wake up frequently at night, although they may not remember waking up. This is called fragmented sleep.¹ “Imagine trying to watch a movie, but every few minutes, something interrupts — like a phone call or a loud noise — so you have to pause and restart each time,” Dr. Ortiz explained. “This is what fragmented sleep is like for your body and brain.”

A fragmented sleep-wake cycle can worsen daytime sleepiness because it prevents your body from getting the deeper, more restorative stages of nighttime sleep it needs.¹

Excessive Rapid Eye Movement Sleep

Rapid eye movement (REM) sleep is the phase of sleep when your brain is active and dreaming.⁴ People with narcolepsy go into REM very quickly after falling asleep and often get too much REM sleep and not enough of the other sleep stages.³

“With narcolepsy, you tend to cycle into REM sleep more often, usually at the expense of other phases of sleep, where your brain is performing other functions,” Dr. Ortiz said. “So when you wake up, your brain may not be ready for the next day.”^3,4

Sleep Paralysis

Some people with narcolepsy experience sleep paralysis as they’re falling asleep or waking up. You’re awake but can’t move your body, which can be scary and unsettling.¹

“During REM sleep, your body is paralyzed head to toe except for your eyes and diaphragm,” Dr. Ortiz explained.⁵ “For humans, this is helpful, as it prevents us from acting out our dreams.¹ However, if you were to suddenly wake up from REM sleep, you’d experience a sensation of not being able to move, or you might feel like someone is sitting on your chest when you’re trying to take a big breath.”⁶

Anxiety

Once you’ve experienced sleep paralysis, you may worry about it happening again. “For some people, it can get so scary that they have anxiety about sleep,” Dr. Ortiz said. “Unfortunately, not getting enough sleep due to that anxiety can actually increase the chances of sleep paralysis happening again.”⁷

Hallucinations

Narcolepsy can also cause vivid hallucinations, which can affect sleep. “Hypnagogic hallucinations occur as you fall asleep, and hypnopompic hallucinations occur as you wake up,” Dr. Ortiz said.⁶ “Sometimes, they can be very vivid and tied with sleep paralysis.¹ These can be so scary, making it hard for you to go back to sleep.”⁶ Hallucinations may also be auditory, where a person hears something, in addition to visual hallucinations.¹

Total Sleep Time

The amount of time it takes to feel rested can vary quite widely among individuals. With so many different devices and apps, it seems that everyone tracks their sleep time. However, how you feel is the most important way to assess the quality of your sleep. Consider keeping a daily journal to monitor how rested you feel when you wake up, and track times during the day that you feel sleepy. It could be helpful information for you to discuss with your doctor.

Other Sleep Disorders

Although narcolepsy can keep you up at night, it may not be entirely to blame for your lack of nighttime sleep — other sleep conditions can occur along with narcolepsy. “People with narcolepsy may have other sleep disorders like sleep apnea, restless legs syndrome, and REM sleep behavior disorder,” Dr. Ortiz said.¹