Understanding Narcolepsy

Symptoms

People suffering from narcolepsy may experience different symptoms of varying intensity and frequency.
• The most common symptom of narcolepsy is an excessive and overwhelming daytime sleepiness that comes on even after adequate nighttime sleep. This Excessive Daytime Sleepiness (EDS) occurs in 100% of people with narcolepsy. People who experience EDS fall asleep at times when they don’t want to or shouldn’t sleep (i.e. while eating, working, driving). 

• Cataplexy is the second most common symptom of narcolepsy. It is present in 60% to 100% of patients with narcolepsy ⁽¹⁾. It’s described as a sudden, brief loss of muscle strength ranging from slight weakness (slurred speech, drooping head, sagging facial muscles) to complete body collapse. Sudden emotional reactions like laughter, anger, surprise, grief, frustration, embarrassment, elation, or sexual arousal can trigger an attack of cataplexy, which lasts anywhere from a few seconds to rarely several minutes. The person remains conscious throughout the episode.
Between 35% and 75% of the patients have one or more cataplexy attacks per day ⁽²⁾. 

• Narcolepsy patients typically have fragmented nocturnal sleep, awakening many times every night and hardly ever experiencing the restorative deep stages of sleep also referred to as slow wave sleep. Disrupted sleep with frequent awakenings is reported in 60% to 80% of patients with narcolepsy ⁽¹⁾.

• Hypnagogic and hypnopompic hallucinations are vivid, frightening dreamlike experiences, which happen when patients are falling asleep (hypnagogic) or waking up (hypnopompic). Hallucinations are reported by 15% to 66% of patients with narcolepsy ⁽¹⁾. 

• Sleep paralysis (17% to 80% of the patients ⁽¹⁾) is a brief inability to talk or move when falling asleep or waking up for a few seconds to several minutes. Although not dangerous, sleep paralysis tends to frighten people who are not yet aware of their condition, especially when accompanied by hypnagogic hallucinations. 

• Automatic behavior is the inadvertent execution of routine tasks while falling asleep or dozing, without retaining memory of performing the action.