Some people with narcolepsy, especially children, gain weight after the onset of the disease. The increase in weight often appears and remains stable after disease onset. Patients with narcolepsy often present with increased body-mass indices. The total sleep time in the 24 hour period is not prolonged. Whether automatic behaviour is caused by ‘microsleep’ or by cognitive impairment due to sleepiness is unknown.įragmented nocturnal sleep often develops later in the course of narcolepsy and is characterized by frequent awakenings lasting minutes to hours. Patients are so sleepy that they cannot recall what happened during these episodes. Sleep paralysis can last from a few seconds up to several minutes in rare cases.Īutomatic behaviour is characterized by continuation of an activity despite sleepiness or falling asleep. Sleep paralysis can be associated with hypnagogic hallucinations. During these episodes patients are mentally awake. Sleep paralysis is an inability to perform voluntary movements while falling asleep or on awakening. However, in narcolepsy people can easily distinguish this symptom from a real perception. The term hallucination is actually not quite correct as it implicates that one is convinced that the sensation is real. Hypnagogic hallucinations can appear while falling asleep (hypnagogic) or while waking up (hypnopompic) and can be auditory, visual, haptic or sensory (feeling something creeping under the cover, feeling of being touched, smelling something is burning etc.).
Cataplexy can be provoked by watching funny movies or by being tickled by a known person. The frequency of cataplexy varies from less than one episode per year to several episodes per day. The duration of cataplexy can last from seconds to several minutes, with a mean of two minutes. It can also be a complete attack, resulting in falls. Sometimes it is a partial attack, limited to facial muscles (head dropping, a jaw tremor, slurred speech) or to the arms or legs (dropping of objects or buckling of the knees). Cataplexy can appear in many different forms. laughter, surprise, positive anticipation etc.). It is defined as a sudden loss of muscle tone triggered by strong emotions, which are mainly positive (e.g. A subject seemingly awake, but not able to perform, will receive less compassion than one who is not able to perform because being clearly asleep.Ĭataplexy is almost pathognomonic for narcolepsy, in that it proves the diagnosis. This expression of EDS may even cause more problems in interpersonal relationships than the sleep attacks. EDS is typically accompanied by a pronounced difficulty to concentrate and to sustain attention during wakefulness, leading to an impaired performance. Short naps have a refreshing capacity in the majority of people with narcolepsy, in contrast to hypersomnolences other than narcolepsy. Sleep episodes are typically irresistible, usually short and refreshing. EDS can occur at any time throughout the day, particularly in monotonous situations. Narcolepsy is better characterized by an inability to remain awake than by an increased sleep need. Cataplexy can then develop after months or years.īy courtesy of the American Narcolepsy Association EDS is often the symptom that first occurs.
Core symptoms are excessive daytime sleepiness (EDS) and cataplexy.
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