Narcolepsy Quiz: Which Screening Questions Predict a Sleep Disorder?

Identifying narcolepsy and other sleep disorders early can help you get the right care and improve your quality of life. While only a sleep specialist can make a formal diagnosis, simple screening questions drawn from validated tools can flag whether you’re at risk. Below, we summarize research-based questions that best predict narcolepsy and related disorders, and offer a brief quiz you can try yourself.

Key Screening Tools

1. Epworth Sleepiness Scale (ESS)
   (Johns MW. 1991)

   • Measures your general level of daytime sleepiness
   • Asks how likely you are to doze off in eight everyday situations
   • Scores ≥10 suggest excessive daytime sleepiness (EDS)

2. Sleep Disorders Questionnaire (SDQ)
   (Douglass et al. 1994)

   • Covers a range of sleep disorders, including narcolepsy
   • Includes questions on cataplexy, hypnagogic hallucinations, sleep paralysis, and fragmented nocturnal sleep
   • Uses multivariate analysis to predict specific disorders

Note: Although the SDQ covers many conditions, only a subset of its questions is strongly predictive of narcolepsy.

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Core Questions That Predict Narcolepsy

Research shows that a combination of these questions offers the highest predictive value for narcolepsy:

1. Excessive Daytime Sleepiness

   • “How likely are you to doze off or fall asleep during the day without intending to?”
   • Rate your chance in situations like watching TV, sitting quietly after lunch, or as a passenger in a car for an hour without a break.
   • Do this for all eight ESS items—higher total scores (0–24) indicate greater sleepiness.

2. Cataplexy (Sudden Muscle Weakness)

   • “Have you ever experienced a sudden loss of muscle tone triggered by strong emotions (laughter, surprise, anger)?”
   • Even mild episodes (head nodding, jaw dropping) count.
   • Frequency and triggers help distinguish narcoleptic cataplexy from other causes.

3. Sleep Paralysis

   • “Have you ever felt unable to move or speak just as you’re falling asleep or waking up?”
   • Brief episodes (seconds to minutes) of complete muscle atonia are common in narcolepsy.

4. Hypnagogic/Hypnopompic Hallucinations

   • “Do you ever experience dreamlike, vivid images or sounds just as you’re falling asleep (hypnagogic) or waking up (hypnopompic)?”
   • These hallucinations can be visual, auditory, or tactile.

5. Fragmented Nighttime Sleep

   • “Do you wake up frequently during the night and have trouble falling back asleep?”
   • Although narcoleptics may fall asleep quickly, their sleep can be disrupted.

6. Automatic Behaviors

   • “Do you ever continue performing an activity (typing, driving, eating) without remembering it afterward?”
   • Episodes of “microsleeps” or brief lapses can lead to unintentional actions.

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Sample “Narcolepsy Quiz”

Try answering the following. Keep a note of how often you experience each symptom:

• Never (0)
• Rarely (1)
• Sometimes (2)
• Often (3)
• Always (4)

1. Dozing Off
   How likely are you to doze off in these situations?

   • Sitting and reading
   • Watching TV
   • Sitting inactive in a public place
   • As a passenger in a car for an hour

2. Muscle Weakness (Cataplexy)
   Have you ever experienced sudden muscle weakness when laughing, angry, or surprised?

3. Sleep Paralysis
   Have you ever felt unable to move or speak when falling asleep or waking up?

4. Hypnagogic/Hypnopompic Hallucinations
   Have you experienced vivid, dreamlike images or sounds as you drift off or awaken?

5. Nighttime Awakenings
   Do you wake up frequently and struggle to fall back asleep?

6. Automatic Behaviors
   Have you ever driven somewhere or continued a task without memory of doing so?

Interpreting Your Score

• Low Risk: Total daytime sleepiness score <10, and none of the other items rated “Often/Always.”
• Moderate Risk: Score 10–14 on daytime sleepiness plus one or two additional symptoms (cataplexy, sleep paralysis, hallucinations).
• High Risk: Score ≥15 on daytime sleepiness and two or more additional symptoms.

If you fall into the moderate or high-risk categories, consider a formal evaluation.

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Next Steps

• You might consider doing a free, online symptom check for narcolepsy to get more tailored feedback.
• Keep a sleep diary for 1–2 weeks: record bedtimes, wake times, naps, and any symptoms.
• If you suspect narcolepsy or another serious sleep disorder, please speak to a doctor. Only a healthcare professional can confirm a diagnosis and recommend tests like polysomnography (sleep study) or the multiple sleep latency test (MSLT).

Remember, early identification and treatment can dramatically improve day-to-day functioning, safety, and overall well-being. If any of your symptoms feel life threatening—such as severe daytime sleepiness while driving—seek medical attention immediately.