Part 1: What Is Narcolepsy? (A Series On Sleep Difficulty)

Join us as we share a weekly blog post series from the National Institute of Health on the topic of sleep disorders and Narcolepsy

A Series On Sleep Difficulty

What Is Narcolepsy?

Narcolepsy is a chronic sleep disorder with no known cause. The main characteristic of Narcolepsy is excessive and overwhelming daytime sleepiness, even after adequate nighttime sleep. A person with Narcolepsy is likely to become drowsy or to fall asleep, often at inappropriate times and places. Daytime sleep attacks may occur with or without warning and may be irresistible. These attacks can occur repeatedly in a single day. Drowsiness may persist for prolonged periods of time. In addition, nighttime sleep may be fragmented with frequent awakenings. Three other classic symptoms of narcolepsy, which may not occur in all patients, are:

  • Cateplexy: sudden episodes of loss of muscle function, ranging from slight weakness (such as limpness at the neck or knees, sagging facial muscles, or inability to speak clearly) to complete body collapse. Attacks may be triggered by sudden emotional reactions such as laughter, anger or fear and may last from a few seconds to several minutes. The person remains conscious throughout the episode.
  • Sleep paralysis: temporary inability to talk or move when falling asleep or waking up. It may last a few seconds to minutes.
  • Hypnagogic hallucinations: vivid, often frightening, dream-like experiences that occur while dozing or falling asleep.

Daytime sleepiness, sleep paralysis and hypnagogic hallucinations can also occur in people who do not have narcolepsy. In most cases, the first symptom of narcolepsy to appear is excessive and overwhelming daytime sleepiness. The other symptoms may begin alone or in combination months or years after the onset of the daytime sleep attacks. There are wide variations in the development, severity, and order of appearance of cataplexy, sleep paralysis, and hypnagogic hallucinations in individuals. Only about 20 to 25 percent of people with narcolepsy experience all four symptoms. The excessive daytime sleepiness generally persists throughout life, but sleep paralysis and hypnagogic hallucinations may not. The symptoms of narcolepsy, especially the excessive daytime sleepiness and cataplexy, often become severe enough to cause serious disruptions in a person’s social, personal and professional lives and severely limit activities.

When Should You Suspect Narcolepsy?

You should be checked for narcolepsy if:

  • you often feel excessively and overwhelmingly sleepy during the day, even after having had a full night’s sleep;
  • you fall asleep when you do not intend to, such as while having dinner, talking, driving or working;
  • you collapse suddenly or your neck muscles feel too weak to hold up your head when you laugh or become angry, surprised or shocked;
  • you find yourself briefly unable to talk or move while falling asleep or waking up.
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