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Narcolepsy Nursing Guide

The content for this course was created by Tiffany Fields, RN, BSN, MSN, DNP, CRNP

Narcolepsy Overview

This course is intended as a Quick Reference for narcolepsy and will cover an overview and nursing considerations utilizing the nursing process. 

Narcolepsy Etiology and Epidemiology 

Narcolepsy directly affects the brain’s ability to control sleep-wake cycles. It is a chronic condition where individuals will experience interrupted, uneven sleep. They will frequently awaken during sleep cycles and can experience vivid dreams with images or hallucinations. 

The condition can have a negative impact on overall life and daily activities. Within a normal sleep cycle, the individual will enter REM sleep after about 90 minutes and the brain will cause the body to be limp, decreasing the chances of acting out dreams during the night. An individual with narcolepsy will enter REM sleep within 15 minutes of falling asleep. At times, the individual will go limp just after waking up or before falling asleep. Therefore, if the condition is undiagnosed or untreated, it will affect psychological, social, and cognitive function (Ferri, 2020). Additionally, narcolepsy can impair development, causing a delay in academic, work, and social activities (Ferri, 2020). 

Narcolepsy Diagnosis 

To diagnose for narcolepsy, providers should perform a clinical examination and get a detailed medical history. They should also ask the individual to provide a sleep journal to track the condition. Additionally, diagnostic testing through a polysomnogram and a multiple sleep latency test can be performed. 

Narcolepsy Management 

Since there is no cure for narcolepsy, the goals for treatment are to: 

  • Improve or maintain quality of life 
  • Utilize medication and lifestyle changes to control the condition 

Narcolepsy Nursing Care Plan

Nursing Considerations 

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with narcolepsy are listed below. 

Narcolepsy Assessment 

Signs and Symptoms: 

  • Excessive daytime sleepiness 
  • Cataplexy 
  • Sleep paralysis 
  • Hallucination 
  • Fragmented sleep and insomnia 
  • Automatic behaviors (e.g., falling asleep when eating) 

Nursing Diagnosis/Risk For 

  • Sleep disturbance 
  • Falls 
  • Infections 
  • Wandering 
  • Social isolation 
  • Self-care deficit 
  • Impaired communication 
  • Disturbed thought process 

Interventions 

  • Collect baseline cognitive level. 
  • Assess the ability to read, write, and comprehend. 
  • Develop a daily routine. 
  • Allow rest time. 
  • Avoid reality checks. 
  • Provide time to respond to stimuli. 
  • Allow time with activities. 
  • Maintain weight. 
  • Assist with the activities of daily living. 

Expected Outcomes 

  • Remain safe and free from injury. 
  • Maintain a regular sleep schedule. 
  • Maintain a full state of alertness. 
  • Exercising daily. 
  • Be able to relax before bed. 

Individual/Caregiver Education 

  • Avoiding caffeine 
  • Eating a healthy diet 
  • Getting enough rest 
  • Reporting behavioral changes 
  • Keeping a daily schedule 
  • Avoiding activities that cause behavioral changes 
  • Avoiding smoking 
  • Assisting with activities of daily living 
  • Avoiding large meals before bed 
  • Finding local support 

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Additional Information

Content Release Date

4/1/2022

Content Expiration

12/31/2024

Course Contributor 

The content for this course was created by Relias staff writer Tiffany Fields, RN, BSN, MSN, DNP, CRNP. Tiffany has been a clinical nurse for over 20 years. She was educated and trained as a Licensed Practical Nurse in Alabama, where she practiced as a Gerontological Nurse at the local Nursing Homes. She earned her Associate, Bachelor’s and Master’s degrees in Nursing and a Doctorate in Nursing Practice. She also as a Certified Family Nurse Practitioner degree. Her clinical expertise is Adult-Geriatric Nursing and Medical-Surgical medical complexity. She is currently Assistant Director of Nursing at a Rural Hospital as well as a writer for Relias.

Resources 

References 

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