WHY YOU CAN’T STAY AWAKE: SYMPTOMS OF NARCOLEPSY
In addition to daytime sleep attacks, the primary symptoms of narcolepsy include sleep paralysis, hallucinations, and cataplexy. Sleep paralysis—sudden inability to move—occurs at the beginning or the end of sleep and renders immobile virtually every voluntary muscle except those around the eyes. When hallucinations are present, they usually come at the beginning of sleep; they may be vivid, realistic, and sometimes violent.Cataplexy—an attack of muscle weakness or dysfunction lasting from a few seconds to a few minutes—is one of the most disconcerting features of narcolepsy, largely because of the suddenness with which it appears. An attack can be triggered by almost any form of emotional arousal, from anger to athletic activity to excitement—even the mere anticipation of excitement. A mother of three told me she had to allow her children to run amok; she was unable to discipline them because doing so would trigger an attack. Another patient reported that his fraternity brothers considered it an evening’s entertainment to regale him with jokes, just to get him to laugh so that they could watch him collapse. Another described his sadness at having to stay away from Yankees baseball games. During any thrilling moment, he said, just as the other fans were rising to their feet, he would crumple to the floor of the stands. In one case reported in the literature a patient became cataplectic every time he had an orgasm. He had naturally come to believe that such paralysis was simply part of the sexual experience. Sometimes the consequences can be disastrous. A narcoleptic butcher fell asleep while wielding a meat cleaver and awakened to find he had lopped off three of his fingers.Cataplexy may involve all of the muscles or just a select few; the severity ranges from a slight loss of tone to complete paralysis. Victims do not lose consciousness. Not all narcoleptics experience cataplexy; in some, however, the attacks are frequent. People with narcolepsy may notice excessive daytime sleepiness as much as a year before the onset of cataplexy.Memory difficulties are also reported by about half of narcoleptics. In addition, some experience symptoms in the eyes: fatigue, difficulty focusing, double vision. Except for cataplexy, however, these symptoms are not unique to narcolepsy but are found in other disorders as well.*151\226\8*
