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
Hypnagogic hallucinations and excessive daytime sleepiness (EDS) symptoms
Hypnagogic hallucinations may be present in up to 50% of patients with narcolepsy. Hypnagogic hallucinations are dream-like experiences that occur during the transition from wakefulness to sleep, whereas hypnopompic hallucinations occur during the transition from sleep to wakefulness. These hallucinations may involve hearing, vision, touch, balance, or movement. They often incorporate images of the patient's environment into the dream-like images. The hallucinations are frequently vivid, bizarre, frightening, and disturbing for the patients. As a result, the patients may become fearful that they have or will develop a mental illness.
Excessive daytime sleepiness (EDS)
The main symptom of narcolepsy, excessive daytime sleepiness (EDS), causes the patient to tend to fall asleep easily. This can happen in relaxed situations and also at inappropriate times and places. Patients may fall asleep while watching TV, reading a book, driving, attending a meeting, or engaging in a conversation. The daytime sleepiness is present even after normal nighttime sleep. Patients may describe this symptom as being tired, fatigued, sleepy, feeling lazy, or having low energy.
Excessive daytime sleepiness is present throughout the day but the patient, with extreme effort, may be able to resist the sleepiness for some time. Finally, it becomes overwhelming and results in a sleep episode of varied duration (seconds to minutes). In addition to daytime sleepiness, repetitive, irresistible, and unintentional, sudden attacks of sleep may occur throughout the day. Excessive daytime sleepiness usually impairs a patient's functioning because it reduces motivation and vigilance, interferes with concentration and memory, and increases irritability.
Sleep paralysis symptoms
Sleep paralysis may be present in up to 50% of patients with narcolepsy. Sleep paralysis is a temporary inability to move or talk that occurs during sleep-to- wake or wake-to-sleep transitions. It may feel like muscle paralysis, but it is not the same thing. Episodes of sleep paralysis may last seconds to minutes. They can occur at the same time as hypnagogic (or hypnopompic) hallucinations. During sleep paralysis, breathing is maintained, although some patients may experience a frightening sensation of not being able to breathe.
Cataplexy, hypnagogic hallucinations, and sleep paralysis in patients with narcolepsy are referred to as REM related abnormalities because they are caused by REM sleep intrusions into wakefulness. (See the discussion of REM sleep in the section on sleep laboratory tests below.)
Next: What causes narcolepsy?
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