John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Narcolepsy defintion and facts
- What is narcolepsy?
- What are the signs and symptoms of narcolepsy?
- Narcolepsy with cataplexy symptoms
- Hypnagogic hallucinations and excessive daytime sleepiness (EDS) symptoms
- Sleep paralysis symptoms
- What causes narcolepsy?
- How is narcolepsy diagnosed?
- What medications are used for the treatment for narcolepsy with cataplexy?
- What medications are used for the treatment of narcolepsy with EDS?
- Non-drug treatments
- Can narcolepsy be cured?
- How many people have narcolepsy?
- For more information on narcolepsy
- What specialists treat narcolepsy?
- Find a local Sleep Specialist in your town
What are the signs and symptoms of narcolepsy?
Signs and symptoms of narcolepsy include:
- Excessive daytime sleepiness
- Hypnagogic hallucinations
- Sleep paralysis
- Disturbed nocturnal sleep
- Automatic behavior
- Other complaints such as blurred vision, double vision, or droopy eyelids
Other signs and symptoms include:
Disturbed nocturnal sleep with frequent awakenings and increased body movements may develop after the onset of the primary symptoms of narcolepsy. This additional symptom, along with excessive daytime sleepiness and the REM related abnormalities (cataplexy, hypnagogic hallucinations, and sleep paralysis), from the so-called "narcolepsy pentad" (a set of five symptoms).
Automatic behavior may occur in 60% to 80% of patients with narcolepsy. Automatic behavior is when patients carry out certain actions without conscious awareness, often with the unusual use of words (irrelevant words, lapses in speech). This behavior occurs while the patient is fluctuating between sleep and wakefulness.
Other complaints associated with narcolepsy may include eye disturbances due to sleepiness, such as blurred vision, double vision, and droopy eyelids.
Narcolepsy with cataplexy symptoms
Cataplexy is a sudden, temporary loss of muscle control in a person with narcolepsy. An attack of cataplexy usually is triggered by strong emotional reactions such as laughter, excitement, surprise, or anger. Factors that contribute to the attacks of cataplexy include physical fatigue, stress, and sleepiness.
Severe attacks of cataplexy may result in a complete physical collapse with a fall to the ground and risk of injury. Milder forms of cataplexy are more common. These involve regional muscle groups and result in symptoms such as a drooping head, sagging jaw, slurred speech, buckling of the knees, or weakness in the arms. This muscle weakness can be quite subtle. The patient is conscious but usually unable to speak.
Cataplectic attacks may last from a few seconds to several minutes. They may vary from a few per year to numerous attacks per day that could disable the patient. Cataplexy is present in nearly 75% of patients with narcolepsy, according to the National Institutes of Health. The onset of cataplexy may coincide with the onset of excessive daytime sleepiness, but cataplexy often develops years later, so the absence of cataplexy should not rule out the diagnosis of narcolepsy.
Other symptoms may seem unrelated, but may accompany cataplexy. A study in the American Academy of Sleep Medicine also found that nearly one-quarter of patients with narcolepsy/cataplexy reported binge eating at least twice a week.
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