Clinical Services

Treatment for Narcolepsy in Northern Virginia

Narcolepsy is a chronic sleep disorder that causes extreme fatigue and sleepiness. Individuals with this sleep condition often find it difficult to stay awake, regardless of the time of day or what task they are in the middle of completing.

Dr. Seth Tuwiner provides comprehensive testing and treatment for narcolepsy at his offices in Leesburg and Dulles, VA. Learn more about your treatment options and call the Virginia Center for Neuroscience today at (703) 293-5244.

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Narcolepsy Type 1 and Type 2

There are two distinct types of narcolepsy. Type 1 narcolepsy is characterized by sleepiness that is accompanied by sudden loss in muscle tone, otherwise known as cataplexy. This muscle paralysis typically occurs while we are engaged in REM sleep, but can happen at any given moment for those with type 1 narcolepsy. Individuals who do not encounter cataplexy are categorized as having type 2 narcolepsy.

Common Symptoms of Narcolepsy

As a chronic condition, narcolepsy will exist throughout the individual’s life. Symptoms may improve somewhat over time, but will not disappear entirely. Fortunately, these symptoms are not likely to gradually worsen.

Among the most common symptoms of narcolepsy are:

  • Excessive daytime sleepiness (EDS)
  • Hallucinations
  • Cataplexy (only with type 1 narcolepsy)
  • Sleep paralysis
  • Changes in rapid eye movement (REM) sleep
  • Fragmented sleep
  • Insomnia

Individuals with narcolepsy are known to fall asleep while engaged in any number of activities. When this occurs, it is possible for the person to continue said activity for a few moments without a conscious awareness of doing so. This is a unique symptom known as automatic behavior, and is most frequently experienced during habitual tasks such as typing or walking around at home. When the person wakes, they will have no knowledge of what happened while the automatic behavior was being carried out.

In some cases, individuals with narcolepsy may also suffer from other common sleep disorders such as obstructive sleep apnea (OSA) or restless legs syndrome.

Causes and Risk Factors

The exact cause of narcolepsy is unknown, though it is suggested that a person’s hypocretin levels in the body may be an influential factor in those with type 1 narcolepsy. This chemical exists in the brain to assist with regulating times when the body is awake or in REM sleep.

There is little consistency in which people are more or less likely to be diagnosed with narcolepsy. Among the few known risk factors are a person’s age and if they have a family member with the condition. Individuals are usually diagnosed with narcolepsy between the ages of 10 and 30.

How Is Narcolepsy Diagnosed?

In addition to completing a physical exam and review of the person’s medical history, Dr. Seth Tuwiner will often recommend that a patient participate in a sleep study to confirm a diagnosis of narcolepsy. This may be achieved in several different ways, including the maintenance of at-home records in a sleep journal about the individual’s own sleep patterns.

Devices and unique tests may also be administered to record numerical data about the patient and their sleep habits. Many individuals will be asked to wear an actigraph, which is a device worn on the wrist that measures activity and alertness during normal rest periods. Other diagnostic tools commonly used to diagnose narcolepsy include a polysomnography and sleep latency test.

Treatment for Narcolepsy

Once Dr. Tuwiner has a clear idea of an individual’s sleep problems as they relate to narcolepsy, they will begin to offer their insights and preferred treatment options for the patient to explore. While narcolepsy is not curable, it is manageable using various forms of prescribed medications and lifestyle changes.


The type of medication that could be prescribed for a person with narcolepsy can belong to a variety of different pharmaceutical categories. A majority of patients will benefit from taking a stimulant to support their central nervous system, however, the following types of medications have also proven effective in those with narcolepsy:

  • Tricyclic antidepressants
  • Xyrem (specifically for those with cataplexy)
  • Serotonin reuptake inhibitors (SSRIs)
  • Norepinephrine Reuptake inhibitors (SNRIs)

Lifestyle Habits

There are a number of ways that individuals with narcolepsy can manage their condition by making adjustments to their everyday lives. This includes:

  • Establishing a regular sleep schedule
  • Schedule short naps throughout the day
  • Exercise regularly
  • Avoid nicotine
  • Avoid alcohol

When to Contact Virginia Center for Neuroscience

If you begin to experience symptoms of narcolepsy, or notice that your condition is starting to interfere with daily activities, it is best that you seek professional treatment from a specialist. Dr. Tuwiner has many years of experience in the diagnosis and treatment of different sleep disorders like narcolepsy.

To schedule a consultation, please contact our office in Landsdowne today. New patients may call (703) 293-5244.