- Irresistible sleep during daytime hours, inappropriate circumstances
- Usually teens to 20s
- Tetrad of symptoms
- Cataplexy
- sudden decrease or loss of voluntary muscle tone following an emotional trigger—usually laughter, but sometimes anger or surprise.
- can manifest as
- jaw dropping
- head nodding
- arms dropping to the side
- knees sagging
- the patient collapsing to the floor.
- These attacks may last from a few seconds to a few minutes, and the patient’s conscious awareness is preserved.
- The presence of cataplexy is highly specific for narcolepsy
- hallucinations
- upon falling asleep (hypnagogic) and/or
- upon awakening (hypnopompic)
- sleep paralysis
- generalized, transient inability to move or speak during sleep-wake transitions
- Investigations
- EEG
- sleep lab studies
- sleep latency test
- Treatment
- sleep physician
- Cataplexy, sleep paralysis, and hypnagogic hallucinations
- Rx with REM-suppressing antidepressants (venlafaxine or SSRI)
- modafinil (Provigil; 200 to 800 mg daily)
- Stimulants such as
- methylphenidate (Ritalin; 10 to 100 mg daily)
- dextroamphetamine (5 to 60 mg daily)
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