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What are the clinical symptoms suggestive of narcolepsy?
Narcolepsy is a chronic disorder of hypersomnia in which there are sudden onsets of sleep episodes or “sleep attacks” that can be associated with
- Cataplexy
- Sleep paralysis
- Hypnagogic/hypnopompic hallucinations
- Disrupted nighttime sleep
- Daytime sleepiness
Patients with narcolepsy typically experience moderate to severe daytime sleepiness. Symptoms usually begin either in the mid-teens or around the mid-thirties and tend to worsen gradually over time.
On average, there is a delay of about 15 years between the onset of symptoms and diagnosis. The hallmark and only required symptom for diagnosing narcolepsy is the presence of daily, uncontrollable episodes of sudden REM sleep, known as “sleep attacks,” occurring consistently for at least three months.
The diagnosis of narcolepsy (type 1 and type 2) should be confirmed whenever possible by a PSG followed by an MSLT.
In addition, the hypersomnia is not better explained by another sleep disorder, medical or neurologic disorder, psychiatric disorder, medication use, or substance abuse.
References
Slowik JM, Collen JF, Yow AG. Narcolepsy. [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459236/
