Narcolepsy is a sleep disorder that is best known, thanks to Hollywood, for causing people to fall asleep suddenly during the day. Most people with the condition are diagnosed during childhood or adolescence when their symptoms first manifest. Others live with the symptoms for years before receiving an accurate diagnosis.
One of the most common signs of narcolepsy is daytime sleepiness. Many people feel refreshed upon awakening but experience increasing fatigue as the day goes on. For some individuals, this symptom is so severe that they fall asleep in the middle of carrying out work. Other people feel drowsy and low-energy throughout the day despite sleeping through the night. Experts believe people with narcolepsy do not get enough quality sleep at night.
Because patients with narcolepsy experience extreme tiredness, they may have difficulty speaking clearly, slurring words or trailing off in the middle of sentences. This is part of a related condition; cataplexy is the sudden loss of muscle control of the tongue and jaw, which can manifest at random intervals or when a person feels anger or surprise.
People with narcolepsy often struggle to fall and stay asleep at night because their REM cycle functions improperly. Those without the condition experience a period of light sleep followed by a period of deeper, REM sleep, which they usually enter 60 to 90 minutes after falling asleep. Individuals with narcolepsy enter REM sleep earlier in the sleep cycle, sometimes within 15 minutes of drifting off. This disruption in normal sleep patterns exacerbates the excessive daytime sleepiness, which in turn raises the risk of injury.
Narcolepsy can negatively affect concentration and memory; people with the condition may find it difficult to focus during the day. They may struggle to remember details or be unable to remember small blocks of time, often because they have fallen asleep.
Social and Economic Issues
People with narcolepsy may have trouble maintaining their relationships and careers. If the condition is undiagnosed, they may feel isolated or others may feel they are unreliable. Once a person is diagnosed with narcolepsy, treatments can help, but they may still need to find a job that accommodates their condition, which may affect income and general wellbeing.
Cataplexy is often a primary symptom of narcolepsy. Although episodes may only last for a few moments, cataplexy can result in falls or other accidents that can cause serious injuries. The episodes can occur without warning, so the individual does not have time to sit down or pull over if driving. Emotions such as joy, anger, and shock can trigger cataplexy, but because it does not happen every time, the episodes can be difficult to predict.
Hallucinations can be a symptom of narcolepsy. Those that occur when waking up are called hypnopompic hallucinations. More often, people experience hypnagogic hallucinations when falling asleep. The hallucinations are vivid and tangible, causing fear and anxiety. Some people also experience sleep paralysis at the same time, and the events may last from a few seconds to several minutes.
Sleep paralysis, which renders an individual unable to move or speak, can be frightening, especially when it occurs in conjunction with hallucinations. In most cases, the episode will pass on its own, but it can also be interrupted if the affected person is awakened by someone else. Because people are only half awake when these episodes occur, those who have not been diagnosed with narcolepsy may not identify sleep paralysis as a symptom.
Not surprisingly, one of the more common symptoms of narcolepsy is fatigue. A person with the condition rarely gets enough REM sleep, which recharges the body and helps maintains good health. This lack causes individuals to feel lethargic and they may lack the energy to complete daily tasks. Often, people with narcolepsy require more hours of sleep at night and naps during the day, though even this may not alleviate fatigue.
Not all people with narcolepsy experience automatic behaviors. As noted, some find it difficult to recall events from the recent past, but in some cases, they were not sleeping but awake and functioning during the time in question. In addition to the many dangers automatic behaviors pose, people may also feel disoriented after “waking up” from an episode.