Symptoms of Narcolepsy

Narcolepsy is a chronic neurological disorder that severely disrupts the body’s sleeping and waking cycles. It is characterized by extreme daytime drowsiness.

The most prominent symptoms of this condition are sleep attacks (in which the desire to fall asleep is overwhelming), cataplexy (sudden bouts of muscle weakness), and sleep paralysis (a temporary inability to move while falling asleep or waking up).

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Narcolepsy can occur at any age, though onset is most often seen in children, adolescents, or young adults. Given how disruptive this condition can be—especially if untreated—narcolepsy can significantly affect the quality of life and academic or professional performance.

Frequent Symptoms

While narcolepsy is a chronic condition, it doesn’t get worse as you age. The most common symptoms seen in narcolepsy cases result from disruptions in the body’s sleeping and wake cycles. These include:

Excessive Daytime Sleepiness (EDS)

The hallmark of the condition­ (everyone with narcolepsy has it) EDS causes people to become extremely drowsy during the day, leading to sleep attacks. It arises regardless of how much sleep a person gets.

These are short periods in which the desire to sleep comes on quickly and is insatiable. In between sleep attacks, narcoleptic people feel rested and alert.  

Cateplexy

A significant portion of narcolepsy cases also entails cataplexy. This sudden bout of muscle weakness, absence of muscle tone, and loss of voluntary motion often arise when a narcoleptic person experiences strong emotional responses, as in laughter, pangs of fear or stress, or sudden excitement.

The severity of this condition ranges, with some experiencing only a few of these attacks in a lifetime, while others have multiple episodes a day.

In the most severe cases, people retain complete consciousness while experiencing a complete shutdown of bodily motion. Though these episodes—which last a couple of minutes at a time—can be distressing, they’re largely harmless.

Sleep Paralysis

Arising when narcoleptic people are close to falling asleep or just waking up, sleep paralysis is a temporary inability to perform voluntary movements or speak. A condition that lasts anywhere from a few seconds to several minutes, it resembles cataplexy and the state of the body when people are in the dream state of sleep (called REM).

As with these conditions, the debilitation isn’t permanent and doesn’t have lingering effects; people quickly regain the ability to speak and move as expected.   

Hallucinations

Vivid hallucinations often accompany sleep paralysis and may arise when a narcoleptic person is falling asleep (hypnagogic hallucinations) or shortly after waking up (hypnopompic hallucinations). These are most often visual in nature—though other senses can also be affected—and they may take on a frightening or jarring character.

Rare Symptoms

A couple of other symptoms can accompany narcolepsy, though they aren’t necessarily hallmarks of the condition. Here’s a breakdown of some of these rarer symptoms:

Disturbed Sleep

Insomnia or unusual wakefulness at night and inability to sleep can accompany narcolepsy. In these cases, vivid dreams or acting out and moving while dreaming interrupt periods of rest at night.

Automatic Behaviors

In some cases of narcolepsy, a person will have very brief sleep episodes—lasting no more than a couple of minutes—while performing other tasks. Usually occurring when they’re performing routine tasks, they will fall asleep momentarily but still continue whatever they are doing.

Tasks performed while asleep are impaired, however, and people won’t have a conscious memory of doing them.

Other Effects

Some patients with narcolepsy report depression, fatigue, inability to concentrate, and impairment of memory. This condition is also associated with sleep apnea and restless legs syndrome (uncontrolled motion of the feet or legs).

Complications/Sub-Group Indications

Overall, narcolepsy is estimated to occur in about one in every 2,000 people, though the numbers may be higher because this condition is often misdiagnosed or not diagnosed at all.

It occurs just as frequently in men and women, and onset can happen at any age. However, in most cases, narcolepsy arises between the ages of 7 and 25, with symptoms worsening over the first one to two decades after onset, before leveling off.

While the symptoms of narcolepsy remain relatively consistent and are not progressive, their severity and frequency can vary a great deal. More severe cases lead to more frequent and disruptive bouts of sleep attacks, for instance, or will remain asleep for up to an hour after each episode.

Others may experience serious problems as a result of cataplexy or become endangered by regular automatic behaviors.

When to See a Doctor

One of the challenges surrounding narcolepsy diagnosis is that the condition isn’t very well understood, and doctors often mistake it for another condition or miss it entirely. If you think you may be narcoleptic, you’ll need to be referred to a sleep specialist, who can provide a comprehensive assessment of your case.

While the symptoms, themselves, aren’t lethal, they’re certainly disruptive, and they can cause car accidents, falls, or other issues. If you or a loved one is experiencing EDS or the other symptoms—and they’re significantly hindering your social or professional life or putting you in danger—it’s time to seek help.

Finally, if you’ve already been diagnosed with narcolepsy and are managing the condition, you should also call your doctor if the symptoms return (or are unchanged) or become more severe.

A Word From Verywell

There’s more that doctors need to learn about narcolepsy, and, ultimately, there is no cure. The good news is that this chronic condition can be effectively managed.

As research into the causes of this disease continues, there’s no doubt that the range of treatments and preventative approaches to it will continue to grow. It’s safe to say that the future is growing brighter for the narcoleptic population.

Nonetheless, it can be challenging to live with narcolepsy. Not only are the symptoms very disruptive in their own right, but they can also seriously undermine the quality of life and overall safety. There can also be cumulative, long-term effects on emotional and psychological health.

If you or a loved one have narcolepsy, it’s essential to get medical help and enlist family and friends' aid. With the right network of support, narcolepsy can be taken on, and critical to that work is knowing the signs and symptoms of this disease.    

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Article Sources
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  1. National Institutes of Health. Narcolepsy. MedlinePlus. Published 2018.

  2. National Institute of Neurological Disorders and Stroke. Narcolepsy fact sheet. Updated 2020.

  3. National Organization of Rare Disorders. Narcolepsy. Updated 2017.