What are the early signs of narcolepsy?

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 29, 2024.

Official Answer by Drugs.com

One of the earliest signs of narcolepsy is suddenly falling asleep during the daytime, even if you have had a full night’s sleep. This excessive sleepiness is like a “sleep attack” or an overwhelming sense of sleepiness that comes on quickly, and narcolepsy should be considered if a child or teen habitually falls asleep in class, or an adult finds themselves constantly dozing off at work, despite having had a full night's sleep. In between these sleep attacks, people with narcolepsy have normal levels of alertness, particularly if they are doing something that keeps their attention. Narcolepsy most commonly starts in young adults, aged 15 to 25, although it can occur at any age.

Sleep attacks are a hallmark of narcolepsy and are experienced by 100% of people with the condition. The following are other symptoms of narcolepsy, but these are only experienced by 10 to 25 percent of people:

Cataplexy – This symptom may appear weeks or years after the onset of excessive daytime sleepiness, although in about 10% of people this is the first symptom to appear. Cataplexy is sudden muscle weakness that may cause your eyelids or face to droop, your head to drop, or your knees to give way. It is usually triggered by strong emotions like embarrassment, laughter, surprise, or anger. But even during the most severe attacks, people remain fully conscious. Most episodes last a few minutes at the most and get better by themselves.
Sleep paralysis – This is a short-lived inability to move or speak that only lasts a few seconds or minutes that resembles cataplexy but only occurs while falling asleep or waking up. As with cataplexy, people remain fully conscious.
Hallucinations – These are very vivid and sometimes frightening hallucinations that usually occur when people are falling asleep or waking up. They are usually visual but any of the other senses can be involved.

Disturbed nighttime sleep or fragmented sleep affects up to 50% of people with narcolepsy. Sleep may be disrupted by vivid dreaming, insomnia, sleep apnea, acting out while dreaming, or periodic leg movements.

Carrying on with automatic behaviors, such as typing, drawing, eating, or even driving while experiencing a temporary sleep episode can also occur in some individuals with narcolepsy. They cannot recall their actions, and their performance is almost always impaired, for example, their handwriting may degenerate into an illegible scrawl or they store items in bizarre locations and then forget where they placed them. If the episode occurs while driving, the individual may get lost or have an accident. People usually awaken from these episodes feeling refreshed and find that their drowsiness and fatigue have temporarily subsided.

How do you test for narcolepsy?

The main test used to help diagnose suspected narcolepsy is an overnight sleep study (called a polysomnogram) followed the next day by the Multiple Sleep Latency Test (MSLT). A polysomnogram records brain waves, eye movements, muscle tone, and breathing across a night of sleep. This evaluates the amount and quality of night-time sleep and can look for any evidence of an additional sleep disorder (such as sleep apnea or periodic limb movements in sleep). The MSLT is a series of five scheduled naps spread across the day and it is done the day after the polysomnogram so a doctor can determine whether the prior night’s sleep could be affecting the daytime naps. Every 2 hours, the person is allowed to sleep for 20 minutes or more. Continue reading

How should Adderall make you feel, with or without ADHD?

Adderall is a stimulant medication that contains dextroamphetamine and amphetamine. It is FDA approved to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. People taking Adderall for ADHD typically notice improved focus and attention and reduced impulsivity. In people without ADHD, it can also enhance focus, alertness, and energy levels. Continue reading

Modafinil (Provigil) vs Adderall: What's the difference?

Modafinil and Adderall are both classified as CNS stimulants but have different chemical structures, which means there are differences in their addiction potential and risk of side effects. Modafinil and Adderall both have stimulant-type effects, but modafinil is a much milder stimulant than Adderall.

What are the early signs of narcolepsy?

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