What is narcolepsy? What are the symptoms of narcolepsy? How do I know I have it? I need answers… 

Narcolepsy has been listed as a “Rare Disease” by the National Institutes of Health (NIH) . But would you, readers, consider it rare if 1 in every 1,500 people in America is afflicted with the disease? That’s about 200,000 people suffering from narcolepsy. And less that 50,000 are diagnosed and given proper treatment. Why? One of the reasons would be failure to recognize its clinical manifestations.

Did I get your attention? Narcolepsy, if you are not familiar with it, is a neurological disorder characterized by excessive daytime sleepiness and sudden sleep attacks even when in the middle of an activity. This disorder has something to do with the impaired ability of the central nervous system to communicate signals from the brain to the parts of the body involved in sleep. This is thought to be of genetic causes and is a chronic condition.

The major symptom of narcolepsy is excessive daytime drowsiness (EDS). All narcoleptics exhibit this symptom. This is often accompanied with uncontrollable episodes of sleep during the day and muscle weakness. The patient may appear slack-jawed, unable to speak, or might slump or fall to the ground. The attacks may last from a few seconds to several minutes. Symptoms of narcolepsy usually become noticeable when the patient reaches puberty. But in certain cases, symptoms start to surface in their early 30’s.

In addition to EDS, here are the other four symptoms of narcolepsy that completes the so-called “narcolepsy pentad”. 

• Cataplexy. This often accompanies excessive daytime drowsiness and is present in almost 75% of all narcoleptics. Cataplexy is the sudden episodes of muscle weakness characterized by drooping of the eyelids, slumping of the head, slacked jaw, slurring of speech, weakness of the hands and arms and buckling of the knees. This symptom of narcolepsy may be mild and subtle, or it may be severe and result to sudden falls to the ground. This is triggered by intense emotions such as anger, surprise, sadness, excitement, fear, and amusement. Other contributing factors include stress, fatigue and prior sleeplessness. These episodes often don’t last longer than a few minutes and the patient usually remains conscious throughout the episode.
• Hypnagogic hallucinations. These are actually vivid, and often frightening, dreams experienced during transition from the state of wakefulness to the sleep state. The dream is often accompanied by visual, auditory and tactile hallucinations. Some even reports smell and taste being perceived. Around 50% of patients experience this symptom of narcolepsy. These hallucinations are often very disturbing to patients.
• Sleep paralysis. This is experienced by up to 50% of narcoleptics and is often accompanied with hypnagogic hallucinations. This is the temporary paralysis of the skeletal muscle while in the wakefulness-to-sleep transition or the other way around. It could last from seconds to minutes and the patient remains conscious throughout the episode. The paralysis together with the hallucinations can be quite an experience to narcoleptics.
• Automatic behavior. This symptom of narcolepsy is manifested by almost all narcoleptics. This is the continued performance of activities such as eating, driving, walking, talking, writing, etc, while in a state of sleep. The patient is often unaware that he is fluctuating between states of sleep and wakefulness. When asked about the activities done during the episodes, he would have no recollection of ever doing them.

Judging from the major symptoms of narcolepsy mentioned, I can say that another reason why some narcoleptics refuse to seek the proper diagnosis is because they are afraid to find out the truth. Some narcoleptics report that they are scared that they are going crazy and other people might think so too. But this is not a mental disorder. Narcolepsy is a neurological and a sleep disorder and understanding the symptoms of narcolepsy helps us understand narcoleptics more.