Sleep-related issues could range from not getting enough sleep at night to being unable to control when one sleeps. However, persistent inability to sleep and daytime fatigue could be signs of disorders like insomnia and narcolepsy. Notably, both disorders affect sleeping patterns in different ways. Further, insomnia is much more common than narcolepsy. So, learning about the following differences between narcolepsy and insomnia can help in determining the exact cause of poor sleep quality:

1. Effects and types
Narcolepsy disrupts sleep at night and causes sleep attacks during the day, whereas insomnia is associated with trouble falling or staying asleep. Those with insomnia may wake up often at night and be unable to fall asleep again. Further, narcolepsy can be categorized into two main types. Type 1 causes daytime sleepiness and sudden muscle weakness. Type 2 causes excessive daytime sleepiness without muscle weakness. Insomnia can be categorized into five types. Based on duration, one may have acute (short-term) or chronic (long-term) insomnia. Based on symptoms, one may have onset (difficulty falling asleep) or maintenance (difficulty staying asleep) insomnia. The last type, behavioral insomnia of childhood, is when children experience difficulty falling asleep or maintaining sleep.

2. Symptoms
When dealing with narcolepsy, in addition to waking up several times at night, one may suddenly fall asleep while working, in the middle of conversations, or while engaging in other activities. Sleep paralysis—the temporary inability to speak or move when falling asleep or waking up—is also a symptom of narcolepsy. One may also sleepwalk, have vivid dreams, and daydream or hallucinate often. Narcolepsy can also cause cataplexy, i.e., sudden muscle weakness affecting the face, neck, and knees. On the other hand, insomnia is usually limited to trouble falling or staying asleep. Those with insomnia may also stay awake late at night and wake up too early. As a result, they may experience stress, muscle tension, headaches, or pain in other body parts.

3. Prevalence
Narcolepsy is a rare condition, whereas insomnia is a common sleeping disorder that a large percentage of the population experiences.

4. Causes
Narcolepsy is associated with a shortage of nerve cells that produce the brain chemical hypocretin or orexin, which helps promote wakefulness. Insomnia is often associated with issues like a poor sleeping environment, mental health conditions, and lifestyle factors (jet lag, late nights, and more). Besides, people with insomnia either have too much orexin, or the chemical is released at night, keeping them awake.

5. Diagnosis
Narcolepsy can be diagnosed by observing sleep patterns, conducting a multiple sleep latency test (how long it takes one to fall asleep), a sleep study or polysomnography, genetic tests, and a procedure called lumbar puncture to measure the levels of hypocretin. Insomnia can be diagnosed with a physical exam, blood tests, and a sleep study.

6. Treatment
Cognitive-behavioral therapy (CBT) may help treat insomnia, along with relaxation techniques, improving sleeping habits, and sleeping pills. Narcolepsy may require stimulant medications to keep one awake during the day, sodium oxybate to regulate sleep cycles, and lifestyle adjustments to manage sleep attacks.

7. Duration
Narcolepsy is a lifelong condition. It can be managed, but it does not go away completely. On the other hand, insomnia can be chronic or acute, or it may come and go.

Narcolepsy and insomnia may have some overlapping symptoms, but both conditions vary in how they affect sleep and wakefulness. It is important to consult a doctor for an accurate diagnosis.