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Narcolepsy - Daytime sleepiness

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Narcolepsy or Daytime sleepiness is a very serious condition that can have severe repercussions. For the person with narcolepsy, waking hours can be danger zones. Most activities, including driving, working, cooking or even just walking, can be very dangerous if the person doing them falls asleep or loses muscle control unexpectedly.  In addition to the physical danger presented by the condition, people who suffer from narcolepsy often lose control of their lives in many ways.  Some people lose their jobs or are unable to perform them adequately, resulting in financial difficulty. Most lose the ability to drive, thus giving up some freedom and independence and many suffer from depression related to the uncontrollable changes in their lives due to the narcolepsy.  At this point, there is not a cure for narcolepsy so finding a way to treat the symptoms allows many people to keep living a somewhat normal life.

Signs and symptoms

The signs and symptoms of narcolepsy include:

  • Excessive daytime sleepiness. The primary characteristic of narcolepsy is overwhelming drowsiness and an uncontrollable need to sleep during the day. People with narcolepsy fall asleep without warning, anywhere and at any time. For example, you may suddenly nod off while at work or talking with friends. You may sleep for just a few minutes or up to a half-hour before awakening and feeling refreshed, but then you fall asleep again. In addition to sleeping at inappropriate times and places, you also may experience decreased alertness throughout the day. Excessive daytime sleepiness usually is the first symptom to appear and is often the most troublesome, making it difficult for you to concentrate and function fully.

  • Cataplexy. This is the sudden loss of muscle tone. Cataplexy can cause a range of physical changes, from slurred speech to total physical collapse, and may last for a few seconds to a few minutes. Cataplexy is uncontrollable and is often triggered by intense emotions, such as laughter, fear, surprise or anger, or sometimes by strenuous activity. For example, your head may droop uncontrollably when you laugh or your knees may suddenly buckle while you're working out. Some people with narcolepsy experience only one or two episodes of cataplexy a year, while others have numerous episodes each day. About 70 percent of people with narcolepsy experience cataplexy.

  • Sleep paralysis. Less commonly, people with narcolepsy experience a temporary inability to move or speak while falling asleep or upon waking. These episodes are usually brief — rarely lasting for more than 10 minutes — but they can be frightening. You may be aware of the condition and have no difficulty recalling it afterward, even if you had no control over what was happening to you. Normal sleep paralysis is characteristic of the immobility that often accompanies rapid eye movement (REM) sleep, the period of sleep during which most dreaming occurs. The immobility of REM may prevent your body from acting out dream activity.

  • Hypnagogic hallucinations. These hallucinations may take place when a person with narcolepsy falls quickly into REM sleep, as they do periodically during the day. Because you may be semiawake when you begin dreaming, you experience your dreams as reality, and they may be particularly vivid and frightening.

Other signs and symptoms of narcolepsy include restless nighttime sleep and occasional automatic behavior. During episodes of automatic behavior, you continue to function during sleep episodes — even talking and putting things away, for example — but you awaken with no memory of performing such activities. As many as 40 percent of people with narcolepsy experience automatic behavior during sleep attacks.

The first signs and symptoms of narcolepsy usually first appear between the ages of 10 and 25, but the condition can occur at any age. Narcolepsy is chronic, which means signs and symptoms may vary in severity, but never go away entirely. Cataplexy, however, may subside completely.


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