![]() ![]() Young children with narcolepsy find it especially difficult to separate these scary images from their everyday reality. These episodes are not exactly nightmares-although people with narcolepsy, especially children, appear to be more prone to nightmares than others-but REM-stage dreams experienced when the person is semi-awake. After waking, it may take several minutes to readjust to reality and understand that the frightening or threatening situations were only hallucinations. During the hallucinations, a person may be conscious but unable to move or speak even if the images are terrifying. These vivid hallucinations are often very scary. Severe cases involve multiple daily cataplexy attacks that are drug-resistant, with nearly constant sleepiness, and highly disturbed nocturnal sleep.Īpproximately 20 to 60 percent of people with narcolepsy experience vivid hallucinations upon falling asleep (hypnagogic hallucinations) or just after awakening (hypnopompic hallucinations). A diagnosis of moderate narcolepsy can be made when cataplexy occurs daily or every few days, multiple daily naps are needed, and nocturnal sleep is more often disturbed. When cataplexy occurs less than once a week, naps are needed only once or twice a day, and nocturnal sleep is less disturbed, the condition may be diagnosed as mild. Many sleep specialists, therefore, will try to confirm that a patient's cataplexy can be triggered by laughter before making a diagnosis. Some neurological research suggests that the particular repeated fluctuations of muscle activity and vocalizations that laughter produces make it especially likely to trigger cataplexy in individuals with hypocretin deficiency. When cataplexy is a symptom of narcolepsy, as it typically is, those brief episodes of sudden loss of muscle tone after strong emotional moments, with retention of consciousness, must occur at least a few times a month for a diagnosis to be made. Often a clinician will also check a patient's levels of the hormone hypocretin, which helps to regulate both wakefulness and appetite, as a hypocretin deficiency is common in people with narcolepsy. Individuals may also experience bouts of sleep paralysis just before falling asleep or waking up.įor those experiencing frequent symptoms of narcolepsy, the condition can be formally diagnosed by a sleep specialist after an overnight sleep study. For a diagnosis to be made, according to the DSM-5, this excessive sleepiness must be chronic, occurring daily or at least three times per week for at least three months. The core symptom of narcolepsy is the incidence of frequent recurring daytime naps or lapses into sleep. While the severity of symptoms may change over time, narcolepsy is a chronic, lifelong condition but treatment can help to address symptoms. Narcolepsy typically develops in children and young adults and rarely makes a first appearance later in life. Cataplexy episodes may last seconds or a few minutes, but they resolve instantly, and the individual remains conscious and aware throughout, even as their head bobs, their jaw drops, or they collapse to the ground. These disturbing episodes are often preceded by strong emotions-most commonly laughter but also anger, fear, or excitement a person may laugh boisterously, for example, and then experience a sudden loss of muscle tone as their knees buckle or their head drops. In many cases, people with narcolepsy also experience cataplexy, or sudden muscle weakness or paralysis. During severe bouts of sleepiness, they may continue with their normal activities in a kind of automatic state, but may feel dazed and have no memory of engaging in the activity. They may also take multiple "micro-naps," lasting just a few seconds at a time. People with this sleep disorder can experience overwhelming fatigue and uncontrollable sleepiness they nap or fall asleep often throughout the day and can lapse into fully unplanned sleep at any time. ![]() Narcolepsy is a chronic neurological condition that disrupts the normal sleep-wake cycle. ![]()
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