Sleep Attacks, Narcolepsy & Menopause


If you feel you’re having a “sleep attack,” it could be narcolepsy. It isn’t caused by anxiety or a mental illness; it’s a nervous system disorder that happens to 1 in 3,000 Americans.

Narcolepsy is caused by lower brain levels of a protein called hypocretin. The cause is unknown, but it does tend to run in families, and things that have a negative impact on sleep such as late night work schedules, tend to make it worse. As women get in perimenopause or near menopause and have problems with sleep as well as hormonal changes, it can make the symptoms worse.

The most common symptom is extreme drowsiness every 3 to 4 hours during the day and a strong urge to sleep, followed by a short 15 minute nap. It can happen any time: while driving, in the middle of a conversation or after eating. People usually wake up feeling refreshed.

During the attacks, many people say the have hallucinations and experience seeing or hearing things. Sometimes they cannot move and feel paralyzed, or have strong emotions like laughter or anger that can last for only 30 seconds or so.

If you think you could have narcolepsy, talk with your doctor or see a sleep specialist. They will often order some blood tests and an EKG to measure your heart’s electrical activity and an EEG to measure the electrical activity of your brain. There is also a narcolepsy gene found in blood tests as well as specialized sleep tests.

Although there isn’t a cure, there are some things a person can do to help such as eating light or vegetarian meals during the day and avoiding heavy meals right before an important event. Planned naps can also be helpful as can letting people at work or school know about this condition so they won’t think you are bored or lazy.

There are also stimulant drugs, the most common is modafinil (Provigil). Other stimulants also used include dextroamphetamine (Dexedrine, DextroStat) and methylphenidate (Ritalin).

Antidepressant medications used include the selective serotonin reuptake inhibitors (SSRIs) fluoxetine, paroxetine, sertraline, and venlafaxine and the tricyclic antidepressants protriptyline clomipramine, imipramine, and desipramine.

For women in and around menopause, regulating hormones can be helpful. Talk with your doctor about this approach.

Driving restrictions may apply but they vary from state to state.


Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet. 2007 Feb 10;369(9560):499-511.

Morgenthaler TI, Kapur VK, Brown T, Swick TJ, Alessi C, Aurora RN, et al. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep . 2007 Dec 1;30(12):1705-11.



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