What is narcolepsy and what are its clinical manifestations

There are more than 50,000 confirmed cases of narcolepsy in our country, but at the same time, the public's awareness of what narcolepsy is is very low. Some people do not understand the condition of narcolepsy and even think it is just a symptom of sleepiness. However, narcolepsy is a fatal disease that requires patients to treat it seriously and seek medical treatment in a timely manner.

1. What is narcolepsy?

Narcolepsy is a chronic sleep disorder of unknown cause, clinically characterized by irresistible short-term sleep attacks, which often begin in childhood or adolescence. It is often accompanied by other symptoms such as cataplexy, sleep paralysis, and sleep hallucinations, collectively known as the narcolepsy tetrad. The term narcolepsy was first coined by Gelineau in 1880, so this disease is also called Gelineau syndrome.

2. Clinical manifestations

1. Excessive daytime sleepiness

The main manifestation is irresistible short-term sleep attacks during the day, which often occur 3-4 hours after waking up. Although the individual tries to stay awake during the attack, he cannot control himself and quickly falls asleep. Sleep usually lasts for several minutes and may occur multiple times a day. The attacks occur regardless of time, place or activity.

2. Cataplexy

It manifests as a sudden involuntary bowing of the head or sudden falling to the ground, but the patient remains conscious. It usually only lasts for a few seconds and usually only occurs once a day. Cataplexy is caused by a transient or complete loss of partial or total muscle tone.

3. Hallucinations before falling asleep

It manifests as a vivid dream-like experience before falling asleep or waking up, with auditory hallucinations being the most common, but visual and tactile hallucinations may also be seen. Hypnagogic hallucinations occur in 12% to 50% of patients with narcolepsy. Patients may experience vivid and often unpleasant sensory experiences, including visual, tactile, motor, or auditory experiences, before falling asleep or when waking up.

4. Sleep paralysis

Sleep paralysis, also known as sleep paralysis, occurs in 15%-34% of patients with narcolepsy. Sleep paralysis is a terrifying experience in which narcolepsy patients cannot move their entire body or speak when they wake up from sleep, with only breathing and eye movements being unaffected.

5. Automatism

About half of the patients have automatic symptoms. They experience simultaneous or rapid transitions between wakefulness and sleep while seemingly awake, such as inappropriate speech and behavior, aimless long-distance driving, and even shoplifting. These symptoms may last for a few seconds, an hour or longer, and they will completely forget what happened afterwards.

6. Insomnia

Many patients suffer from insomnia. Frequent hypnagogic hallucinations or sleep paralysis may cause intermittent sleep at night and make them unable to sleep through the night. It may also be because of excessive daytime sleepiness that interferes with sleep at night. The total sleep hours of narcolepsy patients in a 24-hour day are no longer than those of normal people.