ArticleJournal of sleep research2026
COVID-19-Induced Narcolepsy Type I With Cataplexy: A Short Report.
Article in Journal of sleep research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Narcolepsy type I is a rare neurological sleep disorder characterised by chronic excessive daytime sleepiness, cataplexy, and low orexin (hypocretin) levels. Infection with SARS-CoV-2 has been linked to neurological and neuropsychiatric sequelae, but cases of post-COVID narcolepsy remain extremely uncommon. We report a previously healthy 42-year-old Caucasian female who developed excessive daytime sleepiness, cataplexy, and hypnagogic/hypnopompic hallucinations within 3 months of confirmed SARS-CoV-2 infection. Polysomnography (PSG) showed disturbed nocturnal sleep with a high arousal index and periodic limb movements and mild sleep apnea, while the multiple sleep latency test (MSLT) showed a mean latency of 1 min with sleep-onset rapid eye movement (REM) periods in all naps. Cerebrospinal fluid hypocretin was markedly reduced (< 40 ng/L), confirming narcolepsy type I. Following the diagnosis, medical treatment was initiated-with methylphenidate for hypersomnolence followed by venlafaxine for cataplexy, which led to a substantial symptomatic improvement, enabling a return to daily functioning. The case contributes to the minimal literature on narcolepsy following COVID-19 and supports hypotheses of autoimmune-mediated destruction of hypocretin-producing neurons triggered by viral infection. Clinicians should maintain a high index of suspicion for primary sleep disorders in patients with persistent fatigue and hypersomnolence after COVID-19, as early recognition and targeted treatment markedly improve outcomes.
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