Narcolepsy symptoms are usually differentiated based on four different main symptoms. These four main narcolepsy symptoms are also named as symptom complex or narcoleptic tetrad. These four symptoms of narcolepsy are sleep compulsions, cataplexies, abnormal sleep patterns, and sleep paralysis.
Narcolepsy symptom #1: sleep compulsion.
Sleeping sickness (popularly known as compulsive slumbering) is often initially manifested only by an all-day increased sleepiness. This may be compounded by imperative sleep attacks. The fatigue increases and concentration problems occur if the narcolepsy patient forces himself to stay awake. Usually, the sleep attacks or irresistible fatigue occur in situations in which healthy people also become sleepy, such as being a passenger, in the twilight (also at public events such as in the cinema or theater), while reading or watching television, during lectures or monotonous work. In addition, narcoleptics also suddenly fall asleep involuntarily when other people are wide awake, for example, due to excitement – for example, while they themselves are giving a lecture.
Narcolepsy symptom No. 2: cataplexy
In addition to daytime sleepiness, some narcolepsy patients experience sudden and brief losses of muscle control, called cataplexies, more or less frequently. In mild cataplexies, only the facial muscles may go limp; severe seizures cause the entire body to slump, which usually appears very dramatic to outsiders. Cataplexies can be triggered, for example, by strong emotions such as laughter (this is also referred to as a laughing fit), fear, anger or surprise. For example, one’s knees may go weak when someone tells a good joke. The narcolepsy patient is fully conscious during cataplexy, but may not be able to open his eyelids. His or her senses function completely normally, and affected individuals also still have control over their excretory functions, unlike epileptics. Cataplexy can last up to half an hour and can be further prolonged by association with emotional states, such as when the individual is angry that he or she cannot stop the cataplexy. Memories of emotions can also trigger cataplexy. Cataplexy is considered a sure symptom of narcolepsy, which makes diagnosis much easier and rules out other sleep disorders.
Narcolepsy symptom #3: Abnormal sleep patterns.
The abnormal sleep rhythm may alternate approximately in a cycle of four hours each of sleep and wakefulness. This rhythm continues at night, which is why narcolepsy sufferers sometimes experience prolonged night-wake phases. Although healthy people also wake up at night, they usually fall asleep again immediately. If the night-wake phases of a narcoleptic are only short, his sleep is nevertheless extremely shallow. Any external influences, such as light, noise or movement (for example, when the partner turns over in the same bed) cause the narcoleptic patient to wake up. In addition, the dream phases are disturbed; affected persons remember their dreams more frequently due to the light sleep and have an increased tendency to nightmares (sometimes continued in the next sleep phase). Light sleep in narcolepsy is not restful and increases the need for sleep and poor concentration during the day.
Narcolepsy symptom #4: sleep paralysis.
Sleep paralysis, similar to catalepsy, is a condition in which the affected person loses control of his or her muscles. Sleep paralysis occurs during the transitional stages of falling asleep or waking up; some describe sleep paralysis as a state between being awake and dreaming. Unlike cataplexy, sleep paralysis is not related to emotions. Another difference is that outsiders can release the immobilized person from rigidity by touch. Unlike the narcolepsy symptoms described above, sleep paralysis is not perceived as uniformly negative by all patients. Some narcoleptics describe the state as pleasant or are better able to deal with unresolved problems during it. Sleep paralysis is particularly unpleasant when it occurs in an uncomfortable position. However, it can be extremely distressing if sleep-related hallucinations occur at the same time.These are often perceived as the most psychologically distressing symptoms of narcolepsy, as the sufferer has apparitions that seem completely real to them. Even after waking up, narcoleptics may remain convinced that a burglar was at their bedside or that they were raped.
