Around 1 in 2000 people
in the US have narcolepsy 2

That adds up to approximately 150,000 people.12 Unfortunately, narcolepsy is often misunderstood, with about half of those affected being undiagnosed.2 Understanding the symptoms of narcolepsy can help you have a better conversation with your doctor.

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Do you feel tired all the time?

It's normal to feel tired sometimes. But people with narcolepsy struggle to stay awake and alert more often than not. It's called excessive daytime sleepiness (EDS), and when it happens regularly, it can keep you from doing your job and enjoying friends and family. While everyone with narcolepsy experiences EDS, there are other symptoms you may also experience.2, 3, 9

The 5 symptoms simplified

You don't need to have all 5 symptoms to have narcolepsy3

See more about these symptoms

C Cataplexy is a sudden, brief loss of muscle strength or control caused by strong emotions.2,3
  • Patients with cataplexy may have a sudden feeling of weakness.3
  • Cataplectic attacks are not the same in everyone.2,3
    • Most often, attacks affect only certain muscles. Sometimes the weakness is subtle, and people may not notice these attacks, but their close friends or family members may see them.2,3,5
    • Some patients have weakness in their whole body and fall to the ground.2,3 This is less common.2
    • The type of cataplexy attack (e.g., head dropping) within one individual is usually the same.2,6
  • Cataplectic attacks may consist of different symptoms, depending on the person. These can include2,3,6:
    • Head dropping
    • Neck weakness
    • Eyelid drooping
    • Drooping of the face or jaw
    • Slurred speech
    • Buckling of the knees
    • Leg weakness
    • Arm weakness
  • Some patients have weakness in their whole body and fall to the ground.2,3 This is less common.2
  • Attacks are often caused by2,3,6:
    • Sudden, strong emotions such as happiness, laughter, surprise, or anger
    • Hearing or telling a joke
  • These attacks usually last for only a short time—from a few seconds to several minutes.3,6
  • All people do not have the same number of attacks. For some people, they are rare. Other people have many attacks each day.3

H Hypnagogic Hallucinations are vivid dream-like events that occur while falling asleep or waking up.2,3
  • Patients with these hallucinations often talk about unwanted visions or nightmares that occur when they are falling asleep or waking up.2,3
  • These hallucinations may also occur with “sleep paralysis,” which may be described as a strange or scary experience of being unable to move or speak when falling asleep or waking up (see Sleep Paralysis below).3
  • Anybody can have one of these hallucinations at some time in his or her life.7 However, if they happen regularly, it could be a sign of narcolepsy.3
  • Patients may have realistic experiences such as2,3:
    • Hearing sounds or words when drifting off to sleep
    • Having a strong feeling that someone or something is in the room

E Excessive Daytime Sleepiness is the inability to stay awake and alert during the day, resulting in unintended lapses into drowsiness or sleep.3
  • Every patient with narcolepsy has excessive daytime sleepiness.3,8 Yet, patients often do not think that this could be a sign of a sleep disorder.4
  • Excessive daytime sleepiness is often the first sign of narcolepsy to occur.3 But patients may not use the words “excessive daytime sleepiness” to describe what they’re feeling.4,8,9
  • Patients may say that they:
    • Have a hard time staying awake while doing everyday things3
    • Are tired4,9
    • Are fatigued4,9
    • Have difficulty concentrating or focusing8,9
    • Are forgetful or have poor memory8,9
    • Are irritable9
    • Have changes in mood9
  • Excessive daytime sleepiness can be disabling. This is because of the high risk of falling asleep — or having a “sleep attack” — while doing everyday things,3 such as:
    • Sitting and reading10
    • Riding in a car10
    • Stopped in traffic while driving a car10
    • Talking to someone2,10
  • Some patients may do things, but not remember doing them. They may say that they felt like they were “on autopilot.”3
  • Some patients may take daytime naps, but these naps only help them feel refreshed for a short period of time.2,3

S Sleep Paralysis is the brief inability to move or speak while falling asleep or waking up.3
  • Patients experiencing sleep paralysis may report:
    • Being aware of what is going on around them, but not being able to move or speak2
    • Feeling like they are not able to breathe3
  • Sleep paralysis and hypnagogic hallucinations often occur together.3
  • Sleep paralysis can be frightening.3
  • Anyone can have sleep paralysis a few times in his or her life, especially if they have been deprived of sleep or have not been getting enough sleep.3,7 If sleep paralysis occurs regularly, it may be a sign of narcolepsy.3

S Sleep Disruption is when sleep is broken up by many awakenings2,3
  • Patients with sleep disruption may:
    • Fall asleep easily but have trouble staying asleep for long periods of time2,3
    • Report poor-quality sleep11

Narcolepsy is a real condition involving nerve cells and chemicals in the brain.1 If any of these symptoms sound familiar to you, use the tools and trackers on this site to explore and help you prepare for a talk with your doctor or a sleep specialist.

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Disclaimer: The content on this site is not meant to replace a conversation with your doctor. Only a doctor can evaluate your symptoms and make a diagnosis.