Narcolepsy is a chronic sleep disorder consisting of recurrent, uncontrollable, brief episodes of sleep during daytime, sudden loss of muscle tone, sleep paralysis, and hypnagogic phenomena.

The cause of narcolepsy is unknown; however, it may be a familial or genetic disorder.

Signs and symptoms may include frequent sleep attacks while eating, standing or conversing, and sleep periods of 5 to 10 minutes with almost instant transition into rapid eye movement (REM) sleep found on testing. Additional signs and symptoms may include: cataplexy; hypnagogic hallucinations; and sleep paralysis. The patient may be roused easily from sleep during the day, while nightmares may interrupt nocturnal sleep.

History and physical examination; use of the Multiple Sleep Latency Test; and nocturnal polysomnography studies may be included in testing for narcolepsy.

Treatment measures may include medications to stimulate wakefulness, tricyclic antidepressants, and planning naps to coincide with known periods of drowsiness.

Symptoms may interfere with work and social relationships as well as reduce the quality of life. Supportive therapy may be needed to assist with distressing symptoms. Safety risks exist for both the patient and others relating to the operation of mechanical equipment such as motor vehicles, or in certain occupations such as security services. Some medications may warrant close observation due to the risk of developing hypertension.

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

• Rate as for epilepsy, petit mal.

• In those cases where there is severe neurologic deficit, consider entitlement under 38 CFR 3.350 [Special monthly compensation ratings]; competency under 38 CFR 3.353 [Determinations of incompetency and competency]; and ancillary benefits under 38 CFR 3.807.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• None.