Identifying Narcolepsy Symptoms Is Important

There are 5 main symptoms of narcolepsy, referred to by the acronym CHESS (Cataplexy, Hallucinations, Excessive daytime sleepiness, Sleep paralysis, Sleep disruption).1 While all patients with narcolepsy experience excessive daytime sleepiness, they may not experience all 5 symptoms.2,3 Looking deeper for these symptoms during the clinical interview may help identify patients with narcolepsy.2,4

The 5 Main Symptoms of Narcolepsy

The burden of narcolepsy goes
beyond symptoms5-8  Explore comorbidities

Cataplexy

Estimated to be present in 65%-75% of patients with narcolepsy9

This most specific symptom of narcolepsy type 1, is the sudden, generally brief (<2 minutes) loss of muscle tone with retained consciousness. It is usually triggered by strong emotions, such as laughter, surprise, or anger.2,3,10

Hallucinations (hypnagogic and/or hypnopompic)

May affect 33%-80% of patients with narcolepsy11

Hypnagogic hallucinations are vivid dreamlike experiences that occur while falling asleep. When they happen while waking up, they are called hypnopompic hallucinations.2,3 These events may occur with sleep paralysis.3

Excessive daytime sleepiness

Affects 100% of patients with narcolepsy9,11,12

Excessive daytime sleepiness is the inability to stay awake and alert during the day, resulting in periods of an irrepressible need for sleep or unintended lapses into drowsiness or sleep.2,3 Excessive daytime sleepiness is the cardinal symptom of narcolepsy and often the most disabling.2

Sleep paralysis

May affect 25%-50% of patients with narcolepsy11

Sleep paralysis is the disturbing, temporary inability to move voluntary muscles or speak during sleep-wake transitions. It is often accompanied by hypnagogic or hypnopompic hallucinations.1-3,13

Sleep disruption

Estimated to affect 30%-95% of patients with narcolepsy11

Sleep disruption (also known as disrupted nighttime sleep) is due to frequent awakenings, resulting in poor quality sleep.2,3,11 Because narcolepsy is a disorder of sleep-wake state instability,14,15 many patients commonly report disruption of nighttime sleep.2,11

Vertical connection of 5 hexagons listing main narcolepsy symptoms spells CHESS

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  12. Thorpy MJ, Dauvilliers Y. Clinical and practical considerations in the pharmacologic management of narcolepsy.Sleep Med. 2015;16(1):9-18.
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  14. Scammell TE. The neurobiology, diagnosis, and treatment of narcolepsy. Ann Neurol.2003;53(2):154-166.
  15. Saper CB, Scammell TE, Lu J. Hypothalamic regulation of sleep and circadian rhythms.Nature.2005;437(7063):1257-1263.