Recognize the Symptoms of Narcolepsy

Important information about narcolepsy to help you talk with your doctor.

Narcolepsy is a chronic, life-disrupting neurologic (involving the nerve cells and chemicals in the brain) disorder in which the brain is not able to regulate sleep-wake cycles normally.1 It is estimated that about 1 in 2000 people in the United States have narcolepsy.2

The symptoms of narcolepsy can be hard to spot and can be a lot like symptoms of other disorders.2-4 If you think you may have characteristics of the symptoms of narcolepsy, talk to your doctor.

C Cataplexy is a sudden, brief loss of muscle strength or control caused by strong emotions.2,3
  • Patients with cataplexy may have a sudden feeling of weakness.3
  • Cataplectic attacks are not the same in everyone.2,3
    • Most often, attacks affect only certain muscles. Sometimes the weakness is subtle, and people may not notice these attacks, but their close friends or family members may see them.2,3,5
    • Some patients have weakness in their whole body and fall to the ground.2,3 This is less common.2
    • The type of cataplexy attack (e.g., head dropping) within one individual is usually the same.2,6
  • Cataplectic attacks may consist of different symptoms, depending on the person. These can include2,3,6:
    • Head dropping
    • Neck weakness
    • Eyelid drooping
    • Drooping of the face or jaw
    • Slurred speech
    • Buckling of the knees
    • Leg weakness
    • Arm weakness
  • Some patients have weakness in their whole body and fall to the ground.2,3 This is less common.2
  • Attacks are often caused by2,3,6:
    • Sudden, strong emotions such as happiness, laughter, surprise, or anger
    • Hearing or telling a joke
  • These attacks usually last for only a short time—from a few seconds to several minutes.3,6
  • All people do not have the same number of attacks. For some people, they are rare. Other people have many attacks each day.3

H Hypnagogic Hallucinations are vivid dream-like events that occur while falling asleep or waking up.2,3
  • Patients with these hallucinations often talk about unwanted visions or nightmares that occur when they are falling asleep or waking up.2,3
  • These hallucinations may also occur with “sleep paralysis,” which may be described as a strange or scary experience of being unable to move or speak when falling asleep or waking up (see Sleep Paralysis below).3
  • Anybody can have one of these hallucinations at some time in his or her life.7 However, if they happen regularly, it could be a sign of narcolepsy.3
  • Patients may have realistic experiences such as2,3:
    • Hearing sounds or words when drifting off to sleep
    • Having a strong feeling that someone or something is in the room

E Excessive Daytime Sleepiness is the inability to stay awake and alert during the day, resulting in unintended lapses into drowsiness or sleep.3
  • Every patient with narcolepsy has excessive daytime sleepiness.3,8 Yet, patients often do not think that this could be a sign of a sleep disorder.4
  • Excessive daytime sleepiness is often the first sign of narcolepsy to occur.3 But patients may not use the words “excessive daytime sleepiness” to describe what they’re feeling.4,8,9
  • Patients may say that they:
    • Have a hard time staying awake while doing everyday things3
    • Are tired4,9
    • Are fatigued4,9
    • Have difficulty concentrating or focusing8,9
    • Are forgetful or have poor memory8,9
    • Are irritable9
    • Have changes in mood9
  • Excessive daytime sleepiness can be disabling. This is because of the high risk of falling asleep — or having a “sleep attack” — while doing everyday things,3 such as:
    • Sitting and reading10
    • Riding in a car10
    • Stopped in traffic while driving a car10
    • Talking to someone2,10
  • Some patients may do things, but not remember doing them. They may say that they felt like they were “on autopilot.”3
  • Some patients may take daytime naps, but these naps only help them feel refreshed for a short period of time.2,3

S Sleep Paralysis is the brief inability to move or speak while falling asleep or waking up.3
  • Patients experiencing sleep paralysis may report:
    • Being aware of what is going on around them, but not being able to move or speak2
    • Feeling like they are not able to breathe3
  • Sleep paralysis and hypnagogic hallucinations often occur together.3
  • Sleep paralysis can be frightening.3
  • Anyone can have sleep paralysis a few times in his or her life, especially if they have been deprived of sleep or have not been getting enough sleep.3,7 If sleep paralysis occurs regularly, it may be a sign of narcolepsy.3

S Sleep Disruption is when sleep is broken up by many awakenings2,3
  • Patients with sleep disruption may:
    • Fall asleep easily but have trouble staying asleep for long periods of time2,3
    • Report poor-quality sleep11