Type 2 narcolepsy is milder than type 1 and doesn’t include cataplexy — a sudden loss of muscle tone triggered by strong emotions. IIt’s characterized by excessive daytime sleepiness (EDS).

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Narcolepsy is a neurological sleep-wake disorder featuring prominent experiences of EDS. Like other sleep-wake disorders, it involves dysfunction of your brain’s ability to maintain a regular pattern of sleeping and waking.

If you’ve been diagnosed with this condition, you may always feel sleepy and can experience sleep attacks, which are overwhelming and sudden urges to sleep. Other symptoms include sleep paralysis, sleep-related hallucinations, and a sudden loss of muscle tone tied to emotions, called cataplexy.

Narcolepsy is broken down into two primary subtypes — type 1 and type 2 — based on levels of the brain protein hypocretin (also known as orexin) and the presence of cataplexy.

Type 2 narcolepsy, once known as narcolepsy without cataplexy, is diagnosed when EDS is present but hypocretin levels are normal, and cataplexy is absent.

The exact causes of narcolepsy aren’t fully understood. Genetics, environmental factors, autoimmunity, and brain injury may all contribute to imbalances of hypocretin thought to underlie primary symptoms.

In narcolepsy type 2, hypocretin levels are often normal, and its causes are less clear. Some experts theorize narcolepsy type 2 represents the early stage in a narcolepsy spectrum of progression, where hypocretin neurons are minimally affected but may continue to deteriorate.

Not everyone diagnosed with type 2 narcolepsy goes on to develop type 1 narcolepsy, though.

The inconsistency in diagnostic markers suggests there’s a more complex pathology in narcolepsy beyond the hypocretin system.

With the exception of cataplexy, most symptoms of narcolepsy occur in both subtypes. Type 2 narcolepsy typically features milder symptoms compared with type 1 narcolepsy.

Signs and symptoms of type 2 narcolepsy can include:

  • EDS
  • sleep attacks
  • insomnia
  • prolonged daytime napping
  • fragmented sleep
  • sleep paralysis
  • hallucinations when waking or falling asleep (hypnagogic hallucinations)
  • vivid dreaming
  • difficulty falling asleep or staying asleep
  • acting out while dreaming
  • leg twitches during sleep

Both narcolepsy subtypes can also contribute to symptoms of general fatigue, depression, and challenges with concentration and memory.

While symptoms of narcolepsy may significantly affect your quality of life, a literature review from 2023 notes that the overall outlook for people is good, and narcolepsy doesn’t usually affect your life span.

Type 1 and type 2 narcolepsy are lifelong conditions. While there’s no cure, treatment and lifestyle changes can help you manage symptoms.

Because type 2 narcolepsy involves irregular sleep-wake patterns, proactive lifestyle modifications focused on your sleep habits are a significant part of symptom management.

Changes a sleep doctor may recommend include:

  • taking short, regularly scheduled naps
  • sticking to a sleep schedule by going to bed and waking up at the same time every day
  • not smoking
  • avoiding alcohol and caffeine several hours before bedtime
  • getting daily exercise
  • not eating too close to bed or having a heavy meal before bed
  • developing a pre-bedtime relaxation routine
  • keeping your bedroom cool, dark, and quiet
  • avoiding electronic screen viewing before bed

You may need to make everyday adjustments to accommodate life with narcolepsy. This might mean enacting safety precautions for driving, cooking, or navigating obstacles like stairs, for example.

In addition to lifestyle changes, type 2 narcolepsy is treated with medications that promote alertness, control cataplexy, and reduce EDS.

Common narcolepsy medications include:

Your sleep doctor may also recommend working with a mental health professional who can supplement your treatment with cognitive behavioral therapy for narcolepsy.

If left untreated, type 2 narcolepsy can negatively affect your daily life. It may impair your productivity at work, your performance in academics, or your ability to safely engage in activities like driving.

While narcolepsy isn’t currently considered a progressive disorder – which means it is not thought to get worse over time, some people with type 2 narcolepsy go on to develop cataplexy and are later diagnosed with type 1 narcolepsy.

Not everyone experiences this path of progression, though. There’s currently no way to know if your symptoms in type 2 narcolepsy will ever worsen or become more frequent.

The Social Security Administration (SSA) doesn’t have an official listing for narcolepsy in its compendium of conditions that qualify for disability benefits. While that means you don’t automatically qualify for disability benefits, it doesn’t mean you can’t be considered for them.

You may be eligible for disability benefits with type 2 narcolepsy if you can prove to the SSA that your symptoms impact your life as much as one of their recognized conditions.

You can learn more about the SSA medical equivalence process by visiting their official website.

Type 2 narcolepsy typically features normal levels of hypocretin and the absence of cataplexy. Symptoms are similar to those in type 1 narcolepsy but are generally milder.

There’s no cure for narcolepsy, but medications, lifestyle changes, and psychotherapy interventions can help improve symptoms and reduce narcolepsy’s impact on your life.