Sleep apnea and narcolepsy are both disorders that affect your sleep, making it difficult to stay awake and alert during the day. However, they’re actually quite different conditions with distinct symptoms, origins, and treatments.

Sleep apnea is a condition that causes a person to stop breathing intermittently as they sleep. The Greek word “apnea” means “without breath.” Sleep apnea is a sleep disorder that also can be considered a breathing disorder.

Narcolepsy is a sleep disorder in which the brain can’t control the body’s wakefulness. Its primary symptom is the sudden strong urge to fall asleep during the day.

Here’s what to know about sleep apnea and narcolepsy.

Symptoms of Sleep Apnea and Narcolepsy

Excessive daytime sleepiness (EDS) is one of the primary symptoms of both narcolepsy and sleep apnea. EDS makes staying awake during the day difficult for people with sleep apnea and almost impossible for people with narcolepsy.

Sleep Apnea

Sleep apnea is a common sleep disorder that’s potentially dangerous because it interrupts a person’s breathing while they sleep. Obstructive sleep apnea (OSA), when the throat relaxes during sleep, is the most common of three types of sleep apnea.

The other types of sleep apnea are:

• Central sleep apnea (CSA), when the brain fails to send a signal to breathe
• Complex sleep apnea, a combination of the other two types

In sleep apnea, breathing interruptions can happen as many as hundreds of times throughout the night. A person can stop breathing for 30 seconds or longer but may be unaware of any issues because they never wake fully. Other symptoms of obstructive sleep apnea include:

• Morning headaches
• Dry mouth upon awakening
• Loud snoring
• Heavy sweating through the night

Narcolepsy

Excessive daytime sleepiness is a defining symptom of narcolepsy. This drowsiness is so severe in people with narcolepsy that they commonly experience “sleep attacks,” where there’s a sudden need to sleep at random times, even while in conversation with another person or while driving.

Another possible symptom of narcolepsy is cataplexy, a sudden loss of muscle tone in response to a strong emotion, such as laughter or anger. People with narcolepsy type 1 experience cataplexy, while narcolepsy type 2 doesn’t involve cataplexy symptoms. Other symptoms of narcolepsy can include:

• Sleep paralysis
• Insomnia
• Hallucinations when falling asleep or waking up

Diagnosing Sleep Apnea and Narcolepsy

To diagnose both sleep apnea and narcolepsy, a doctor takes a detailed report of your sleep and health history and conducts a thorough physical exam. They may order a sleep study and various other tests. They may also ask you to track your sleep habits in a sleep diary.

A diagnosis of narcolepsy is often made after a healthcare provider rules out other potential root causes of excessive daytime sleepiness.

Tests used to diagnose narcolepsy and sleep apnea may include:

• Polysomnography — This is an overnight test performed in a sleep lab that measures a person’s brain waves, breathing, heart rate, and body movements.
• Multiple sleep latency test (MSLT) — This test is also conducted at a sleep clinic to measure how easy it is to fall asleep. It can help diagnose other sleep disorders.
• Actigraphy — This test measures your activity and rest periods using a wearable device called an actigraph. It can be useful in diagnosing narcolepsy by providing data about daytime sleepiness and sleep attacks.
• Lumbar puncture — This procedure involves using a needle to collect spinal fluid. It may show low levels of hypocretin if a person has narcolepsy.
• Home sleep apnea testing — This form of testing involves a device that measures airflow, breathing patterns, and the amount of oxygen in a person’s blood. It may also track the amount of limb movement and the level of snoring during sleep.

What Causes Sleep Apnea and Narcolepsy?

The cause of OSA is usually related to a blocked or narrowed airway. In contrast, researchers are unsure of the exact cause of narcolepsy, but it’s thought to be a combination of genes and environmental factors. This can make OSA easier to identify and treat than narcolepsy.

Sleep Apnea Causes

Obstructive sleep apnea occurs when the muscles in the back of the throat relax too much, block the airways, and disrupt normal breathing.

With central sleep apnea, the airways stay open, but the brain doesn’t tell the body to breathe.

In complex sleep apnea, a combination of brain and airway issues occur.

In all three types, a person may wake partially each time breathing stops, preventing deep sleep.

Narcolepsy Causes

Narcolepsy type 1 (with cataplexy) is linked to low levels of hypocretin. Hypocretin is a neurotransmitter (chemical messenger) that encourages wakefulness and prevents your brain from entering rapid eye movement sleep (REM) sleep. Low hypocretin levels lead to poor sleep.

A combination of genetic, autoimmune, and environmental factors increases a person’s risk for narcolepsy. Sometimes, narcolepsy may occur after a person has an infection of the upper respiratory tract. In rare cases, narcolepsy can develop as a result of head injury, stroke, or tumor.

Can You Have Both Sleep Apnea and Narcolepsy?

It is possible to have both narcolepsy and sleep apnea. In fact, people with narcolepsy are at a higher risk of having other sleep disorders, including sleep apnea, as well as restless legs syndrome and insomnia.

A study of 133 people with narcolepsy found 33 participants also had OSA. One challenge with having sleep apnea and narcolepsy is the delayed diagnosis of narcolepsy. Sometimes, when an OSA diagnosis is made, doctors may assume it’s the sole cause of EDS and do not look for other contributing causes.

Prevalence of Sleep Apnea and Narcolepsy

Narcolepsy is rare. Sleep apnea, on the other hand, is fairly common.

Who Gets Sleep Apnea?

A 2023 study estimated that 30 million people live with obstructive sleep apnea in the United States, and 80 percent of these cases are undiagnosed.

According to the journal Sleep Medicine, OSA is more prevalent among men, African Americans, Native Americans, and Hispanics. The condition can develop at any age, but it’s more common among people over the age of 40 and those who have been diagnosed as overweight.

Who Gets Narcolepsy?

Narcolepsy affects about 1 in 2,000 people in the United States. However, the condition is thought to be underdiagnosed, meaning the number of people with narcolepsy is likely higher.

Narcolepsy affects men and women equally, according to the National Institute of Neurological Disorders and Stroke. It’s most commonly diagnosed in late childhood or young adulthood between the ages of 10 and 30.

How Are Sleep Apnea and Narcolepsy Treated?

Treatment for sleep apnea is usually dependent upon what’s causing the condition. Obstructive sleep apnea can sometimes be cured. In contrast, there is currently no cure for narcolepsy. However, treatment options can help manage the condition and significantly improve your quality of life.

Sleep Apnea Treatments

Most cases of sleep apnea are treated with options including medical devices, medication, surgery, and lifestyle changes. If you suspect you or a loved one might have sleep apnea, it’s important to identify it. Left untreated, sleep apnea can lead to serious, life-shortening medical conditions, including heart problems or even brain damage.

There are several effective treatments for sleep apnea:

• Continuous positive airway pressure (CPAP) — A CPAP device is usually the first treatment for OSA. It gently blows air into a person’s airway to prevent or reduce airway blockage.
• Medication — In late 2024, the U.S. Food and Drug Administration (FDA) approved tirzepatide (Zepbound), a weight-loss medication, to treat obstructive sleep apnea in adults with obesity.
• Oral appliances — There are a variety of FDA-approved oral appliances designed to shift the position of the jaw to help keep the airway open.
• Surgery — Surgery is sometimes recommended, depending on where the airway obstruction occurs.
• Lifestyle and behavior changes — These might include losing weight, sleeping in a different position, or not drinking alcohol before bed.

Narcolepsy Treatments

Narcolepsy treatment can include several different types of medications to help relieve symptoms. These include:

• Stimulant medications to help people with narcolepsy stay awake and alert during the day
• Antidepressants to improve sleep, reduce hallucinations, and treat cataplexy.
• Sodium oxybate treatments that help treat excessive daytime sleepiness and cataplexy.

Lifestyle changes, such as exercising regularly, maintaining a sleep schedule, and taking strategically scheduled naps, may improve nighttime sleep.

If you’re experiencing drowsiness during the day or other symptoms mentioned in this article, talk to your doctor. Sleep apnea is often very treatable.

Find Your Team

MyNarcolepsyTeam is the social network for people with narcolepsy and their loved ones. There, members come together to ask questions, give advice, and share their stories with others who understand life with narcolepsy.

Do you have narcolepsy or sleep apnea or both? What was your diagnostic process like? How do you manage daytime sleepiness? Comment below and or start a conversation on your Activities feed.