Narcolepsy Symptoms

Medically Reviewed by Sabrina Felson, MD on July 16, 2023
2 min read

Narcolepsy is a sleep disorder that causes uncontrollable, severe daytime sleepiness that often happens at the wrong time and place. The daytime sleep attacks may come without warning, and you can have them multiple times a day. People with narcolepsy tend to sleep at night in fragments, waking up often.

Estimates suggest that about 1 in 2,000 people have narcolepsy. But many experts believe that because sleepiness is a common symptom and narcolepsy is relatively rare, it is not the first thing doctors think of leading to a missed diagnosis.

There could be 10 years between when symptoms begin and when you get a diagnosis. About half of adults with narcolepsy report that symptoms began in their teenage years. For most, narcolepsy begins between ages 15 and 30.

You can get treatment for narcolepsy. It’s most effective when it combines medications with lifestyle changes like a regular nighttime sleep schedule and scheduled naps during the day.

The four main symptoms of narcolepsy, from most to least common, are:

  • Excessive daytime sleepiness (EDS)
  • Sudden temporary loss of muscle tone, often triggered by emotions such as laughter (cataplexy)
  • Vivid dream-like episodes while falling asleep or waking up (hallucinations)
  • Paralysis when you’re falling asleep or waking up; you may not be able to move for a few minutes (sleep paralysis)

About 15% of people have all four of these symptoms.

Narcolepsy can also lead to:

  • Trouble concentrating or a foggy brain
  • Memory problems
  • Feelings like uncertainty, embarrassment, or fear
  • Problems at work or school
  • Car accidents
  • A higher risk of conditions like obesity, high blood pressure, or mental health issues

Everyone has severe sleepiness at some point in their lives. But the symptoms of fatigue are different from those of narcolepsy.

Signs of fatigue include:

  • A lack of physical or mental energy
  • Trouble starting an activity or keeping at it
  • Problems focusing, remembering things, or regulating your emotions

When you’re fatigued, you may find that sleep or rest doesn’t restore your energy. Fatigue usually has an underlying cause, like a medication, a health condition, or depression or anxiety.

People with narcolepsy tend to wake up refreshed but have trouble staying awake. It’s a sleep-wake control disorder, which means periods of sleepiness and wakefulness intrude on each other. Experts aren’t sure exactly what causes it.

Many people with narcolepsy notice that their symptoms level off over time. They may even get better or go away entirely.

There’s no cure for narcolepsy. But there are ways to ease symptoms and improve your quality of life.

Tests and sleep studies (also known as polysomnography) can help your doctor diagnose narcolepsy. Then, they can recommend medications and lifestyle changes that are most likely to work for you.