Narcolepsy Quiz
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Tired all the time
Sleep paralysis
Hallucinations
Sudden tiredness during the day
Auditory hallucinations
Tactile hallucinations
Sudden muscle weakness
Excessive daytime sleepiness
Can't stay asleep
Seeing things when waking up
Falling asleep at work
Cataplexy attack
Not seeing your symptoms? No worries!
What is Narcolepsy?
Narcolepsy is a chronic sleep disorder causing excessive daytime drowsiness. The cause is unclear but may involve genetic factors and abnormal nerve cell signaling in the brain. In addition to daytime sleepiness, symptoms include sudden sleep attacks, loss of muscle tone, and, occasionally, hallucinations when awaking from sleep in the the morning.
Typical Symptoms of Narcolepsy
- Episodes of sudden, overwhelming daytime sleepiness
- Headache that worsens with lack of sleep
- Weakness in arms or legs triggered by strong emotions
- Headache that gets worse in the morning
- I frequently have nightmares.
- Experiences sleep paralysis frequently
- Difficulty concentrating
- Excessive daytime sleepiness
Diagnostic Questions for Narcolepsy
Your doctor may ask these questions to check for this disease:
- Do you have episodes of sudden, overwhelming daytime sleepiness?
- Does your headache get worse when you haven't slept enough?
- Do you have weakness in your arms or legs when you feel strong emotions?
- Do your headaches get worse in the morning?
- Do you have frequent nightmares?
Treatment of Narcolepsy
There is no cure for narcolepsy, but medications (stimulants, cognitive-enhancing medications, antidepressants) and lifestyle modifications can improve symptoms.
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Dec 6, 2024
Following the Medical Content Editorial Policy
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Symptoms Related to Narcolepsy
Diseases Related to Narcolepsy
FAQs
Q.
How are tactile hallucinations linked to sleep paralysis?
A.
Tactile hallucinations during sleep paralysis are sensations of touch that feel real but aren't. These can happen because the brain is awake, but the body is still in a sleep state.
References:
McNally RJ, & Clancy SA. (2005). Sleep paralysis in adults reporting repressed, recovered, or .... Journal of anxiety disorders, 15749576.
https://pubmed.ncbi.nlm.nih.gov/15749576/
Cheyne JA, & Girard TA. (2007). a prospective study of sleep paralysis experiences. Consciousness and cognition, 17337212.
https://pubmed.ncbi.nlm.nih.gov/17337212/
Herrero NL, Gallo FT, Gasca-Rolín M, Gleiser PM, & Forcato C. (2023). Spontaneous and induced out-of-body experiences during .... Journal of sleep research, 36053735.
Q.
How are tactile hallucinations related to alcohol withdrawal?
A.
Tactile hallucinations, like feeling things on your skin that aren't there, can happen during alcohol withdrawal, especially in severe cases like delirium tremens.
References:
Miller F. (1982). Prodromal syndromes in delirium tremens. The American journal of drug and alcohol abuse, 7188003.
https://pubmed.ncbi.nlm.nih.gov/7188003/
Platz WE, Oberlaender FA, & Seidel ML. (1995). The phenomenology of perceptual hallucinations in .... Psychopathology, 8559948.
https://pubmed.ncbi.nlm.nih.gov/8559948/
Mayer M, & Masoud A. (2023). Blood Alcohol Level as a Predictor of Withdrawal Severity. Cureus, 37791217.
Q.
How long do cataplexy attacks typically last and how can they be managed?
A.
Cataplexy attacks usually last from a few seconds to a couple of minutes and can be managed with medications like pitolisant, which has been shown to be safe and effective.
References:
Chakravorty SS, & Rye DB. (2003). Narcolepsy in the older adult: epidemiology, diagnosis and .... Drugs & aging, 12696996.
https://pubmed.ncbi.nlm.nih.gov/12696996/
Pillen S, Pizza F, Dhondt K, Scammell TE, & Overeem S. (2017). Cataplexy and Its Mimics: Clinical Recognition and .... Current treatment options in neurology, 28478511.
https://pubmed.ncbi.nlm.nih.gov/28478511/
Szakacs Z, Dauvilliers Y, Mikhaylov V, Poverennova I, Krylov S, Jankovic S, et al. (2017). Safety and efficacy of pitolisant on cataplexy in patients .... The Lancet. Neurology, 28129985.
Q.
Is cataplexy considered dangerous and what precautions should be taken?
A.
Cataplexy is not usually dangerous, but it can cause sudden muscle weakness. People should avoid situations where sudden weakness could lead to injury, like driving or operating machinery.
References:
Overeem S, Lammers GJ, & van Dijk JG. (2002). Cataplexy: 'tonic immobility' rather than 'REM-sleep atonia'?. Sleep medicine, 14592141.
https://pubmed.ncbi.nlm.nih.gov/14592141/
Hershner S, Kakkar R, Chung F, Singh M, Wong J, & Auckley D. (2019). Narcolepsy, Anesthesia, and Sedation: A Survey of the .... Anesthesia and analgesia, 30540615.
https://pubmed.ncbi.nlm.nih.gov/30540615/
Guilleminault C, Billiard M, Montplaisir J, & Dement WC. (1975). Altered states of consciousness in disorders of daytime .... Journal of the neurological sciences, 1185238.
Q.
What are the different types of tactile hallucinations and their causes?
A.
Tactile hallucinations are feelings of touch or movement on the skin that aren't real. They can be caused by drug use, Parkinson's disease, or certain mental health issues
References:
Nakamura M, & Koo J. (2016). Drug-Induced Tactile Hallucinations Beyond Recreational .... American journal of clinical dermatology, 27637620.
https://pubmed.ncbi.nlm.nih.gov/27637620/
Fénelon G, Thobois S, Bonnet AM, Broussolle E, & Tison F. (2002). Tactile hallucinations in Parkinson's disease. Journal of neurology, 12529792.
https://pubmed.ncbi.nlm.nih.gov/12529792/
de Leon J, Antelo RE, & Simpson G. (1992). Delusion of parasitosis or chronic tactile hallucinosis. Comprehensive psychiatry, 1555406.
Q.
What could cause sudden muscle weakness in my legs?
A.
Sudden muscle weakness in your legs can be caused by various factors, including nerve issues, muscle problems, or even infections.
References:
Riggs JE. (1985). Adult-onset muscle weakness. How to identify the .... Postgraduate medicine, 4034446.
https://pubmed.ncbi.nlm.nih.gov/4034446/
Haddad H, & Rotblatt M. (2015). A case report of sudden-onset upper and lower extremity .... The Physician and sportsmedicine, 25556330.
https://pubmed.ncbi.nlm.nih.gov/25556330/
Larson ST, & Wilbur J. (2020). Muscle Weakness in Adults: Evaluation and Differential .... American family physician, 31939642.
Q.
What does a cataplexy attack mean for someone with narcolepsy?
A.
A cataplexy attack in someone with narcolepsy is when they suddenly lose muscle strength, often triggered by strong emotions like laughter or surprise.
References:
Manford E, Garg A, & Manford M. (2024). Drop attacks: a practical guide. Practical neurology, 37891001.
https://pubmed.ncbi.nlm.nih.gov/37891001/
Xu XM, Wei YD, Liu Y, & Li ZX. (2019). Gamma-hydroxybutyrate (GHB) for narcolepsy in adults. Sleep medicine, 31671326.
https://pubmed.ncbi.nlm.nih.gov/31671326/
Poryazova R, Khatami R, Werth E, & Bassetti CL. (2009). Weak with sex: sexual intercourse as a trigger for cataplexy. The journal of sexual medicine, 19493288.
Q.
What is a narcolepsy sleep attack and how can it be managed?
A.
A narcolepsy sleep attack is when someone suddenly falls asleep at any time. Managing these attacks involves medication and lifestyle changes.
References:
Kales A, Vela-Bueno A, & Kales JD. (1987). Sleep disorders: sleep apnea and narcolepsy. Annals of internal medicine, 3544995.
https://pubmed.ncbi.nlm.nih.gov/3544995/
Chavda V, Chaurasia B, Umana GE, Tomasi SO, Lu B, & Montemurro N. (2022). Narcolepsy-A Neuropathological Obscure Sleep Disorder. Brain sciences, 36358399.
https://pubmed.ncbi.nlm.nih.gov/36358399/
Akintomide GS, & Rickards H. (2011). Narcolepsy: a review. Neuropsychiatric disease and treatment, 21931493.
Q.
What is excessive daytime sleepiness disorder and how is it treated?
A.
Excessive daytime sleepiness disorder is when someone feels very sleepy during the day, even after a good night's sleep. It can be treated with lifestyle changes and sometimes medication.
References:
Gandhi KD, Mansukhani MP, Silber MH, & Kolla BP. (2021). Excessive Daytime Sleepiness: A Clinical Review. Mayo Clinic proceedings, 33840518.
https://pubmed.ncbi.nlm.nih.gov/33840518/
Pérez-Carbonell L, Mignot E, Leschziner G, & Dauvilliers Y. (2022). Understanding and approaching excessive daytime .... Lancet (London, England), 36115367.
https://pubmed.ncbi.nlm.nih.gov/36115367/
Takenoshita S, & Nishino S. (2017). Pharmacologic Management of Excessive Daytime .... Sleep medicine clinics, 28778242.
Q.
What is the phenomenon called when you wake up and see things that aren't there?
A.
When you wake up and see things that aren't there, it might be a type of hallucination related to sleep. These experiences can happen during transitions between sleep and waking up.
References:
Bressloff PC, Cowan JD, Golubitsky M, Thomas PJ, & Wiener MC. (2002). What geometric visual hallucinations tell us about the .... Neural computation, 11860679.
https://pubmed.ncbi.nlm.nih.gov/11860679/
Herrero NL, Gallo FT, Gasca-Rolín M, Gleiser PM, & Forcato C. (2023). Spontaneous and induced out-of-body experiences during .... Journal of sleep research, 36053735.
https://pubmed.ncbi.nlm.nih.gov/36053735/
Felthous AR, Wenger PJ, & Hoevet R. (2010). Acute psychosis associated with dissociated sleep- .... Pharmacotherapy, 20334466.
Q.
What methods can help stop or manage tactile hallucinations?
A.
Tactile hallucinations can be managed by addressing underlying causes, such as medication side effects or vitamin deficiencies.
References:
Funakawa I, & Jinnai K. (2005). [Tactile hallucinations induced by trihexyphenidyl in a .... Rinsho shinkeigaku = Clinical neurology, 15782612.
https://pubmed.ncbi.nlm.nih.gov/15782612/
Carter E, Banerjee S, Alexopoulos GS, Bingham KS, Marino P, Meyers BS, et al. (2025). A machine learning approach. Journal of affective disorders, 40187431.
https://pubmed.ncbi.nlm.nih.gov/40187431/
Sahu P, Thippeswamy H, & Chaturvedi SK. (2022). Neuropsychiatric manifestations in vitamin B12 deficiency. Vitamins and hormones, 35337631.
Q.
What might cause me to fall asleep immediately after work, and how can I manage it?
A.
Falling asleep right after work could be due to your body's internal clock being off or working long hours. You can try setting a regular sleep schedule and limiting work hours if possible.
References:
Wagner DR. (1999). Circadian Rhythm Sleep Disorders. Current treatment options in neurology, 11096717.
https://pubmed.ncbi.nlm.nih.gov/11096717/
Virtanen M, Ferrie JE, Gimeno D, Vahtera J, Elovainio M, Singh-Manoux A, et al. (2009). Long working hours and sleep disturbances: the Whitehall .... Sleep, 19544749.
https://pubmed.ncbi.nlm.nih.gov/19544749/
Choi H, Lee S, Jeon MJ, & Min YS. (2020). data from the 5th Korean Working Conditions Survey. Annals of occupational and environmental medicine, 34754456.
Q.
What might cause sudden onset muscle weakness and how can it be treated?
A.
Sudden muscle weakness can be caused by many things, like nerve problems or infections, and treatment depends on the cause.
References:
Larson ST, & Wilbur J. (2020). Muscle Weakness in Adults: Evaluation and Differential .... American family physician, 31939642.
https://pubmed.ncbi.nlm.nih.gov/31939642/
Antoniuk SA. (2013). [Acute muscle weakness: differential diagnoses]. Revista de neurologia, 23897142.
https://pubmed.ncbi.nlm.nih.gov/23897142/
Nayak R. (2017). Practical approach to the patient with acute neuromuscular .... World journal of clinical cases, 28798922.
Q.
What might cause sudden tiredness in the mid-afternoon?
A.
Sudden tiredness in the afternoon can be due to various factors, including poor sleep quality, certain medications, and health conditions affecting sleep.
References:
Cockcroft K, Ashwal J, & Bentley A. (2009). Sleep and daytime sleepiness in methylphenidate .... African journal of psychiatry, 20033109.
https://pubmed.ncbi.nlm.nih.gov/20033109/
Newman AB, Spiekerman CF, Enright P, Lefkowitz D, Manolio T, Reynolds CF, & Robbins J. (2000). Daytime sleepiness predicts mortality and cardiovascular .... Journal of the American Geriatrics Society, 10682939.
https://pubmed.ncbi.nlm.nih.gov/10682939/
Chedraui P, Pérez-López FR, Mendoza M, Leimberg ML, Martínez MA, Vallarino V, & Hidalgo L. (2010). Factors related to increased daytime sleepiness during the .... Maturitas, 19945237.
Q.
Why does muscle weakness occur after a stroke and how can it be rehabilitated?
A.
Muscle weakness after a stroke happens because the brain can't control muscles well anymore, and it can be improved with exercises and therapy.
References:
Gray V, Rice CL, & Garland SJ. (2012). Factors that influence muscle weakness following stroke .... Physiotherapy Canada. Physiotherapie Canada, 23997398.
https://pubmed.ncbi.nlm.nih.gov/23997398/
Rabelo M, Nunes GS, da Costa Amante NM, de Noronha M, & Fachin-Martins E. (2016). Reliability of muscle strength assessment in chronic post- .... Topics in stroke rehabilitation, 26243549.
https://pubmed.ncbi.nlm.nih.gov/26243549/
Ramsay JW, Barrance PJ, Buchanan TS, & Higginson JS. (2011). Paretic muscle atrophy and non-contractile tissue content .... Journal of biomechanics, 21945568.
Q.
Why might I experience hallucinations when waking up?
A.
Hallucinations when waking up might happen because of sleep paralysis or out-of-body experiences, which can occur during sleep transitions.
References:
McNally RJ, & Clancy SA. (2005). Sleep paralysis, sexual abuse, and space alien abduction. Transcultural psychiatry, 15881271.
https://pubmed.ncbi.nlm.nih.gov/15881271/
Herrero NL, Gallo FT, Gasca-Rolín M, Gleiser PM, & Forcato C. (2023). Spontaneous and induced out-of-body experiences during .... Journal of sleep research, 36053735.
https://pubmed.ncbi.nlm.nih.gov/36053735/
Bogan R, Thorpy MJ, Berkowitz S, & Gudeman J. (2025). How once-nightly sodium oxybate is processed in the body .... Journal of comparative effectiveness research, 40151979.
Q.
Can stress lead to or worsen narcolepsy?
A.
Yes, stress can be a cause of or even worsen narcolepsy
References:
BaHammam, Ahmed S., Kholoud Alnakshabandi, and Seithikuruppu R. Pandi-Perumal. "Neuropsychiatric correlates of narcolepsy." Current Psychiatry Reports 22 (2020): 1-11.
Broughton WA, Broughton RJ. Psychosocial impact of narcolepsy. Sleep. 1994 Dec;17(8 Suppl):S45-9. doi: 10.1093/sleep/17.suppl_8.s45. PMID: 7701199.
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https://www.nejm.org/doi/10.1056/NEJMra1500587Hanin C, Arnulf I, Maranci JB, Lecendreux M, Levinson DF, Cohen D, Laurent-Levinson C. Narcolepsy and psychosis: A systematic review. Acta Psychiatr Scand. 2021 Jul;144(1):28-41. doi: 10.1111/acps.13300. Epub 2021 May 5. PMID: 33779983; PMCID: PMC8360149.
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