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These episodes typically begin with weakness of the muscles of the face and neck that then spreads to involve the muscles of the limbs and trunk. Cataplexy.Ĭataplexy is characterized by sudden, emotionally triggered episodes of muscle weakness with preserved consciousness. REM sleep can occur in persons with narcolepsy at any time of day, and the classic elements of REM sleep often intrude into wakefulness, creating peculiar intermediate states. REM sleep normally occurs only during the usual sleep period and includes vivid, storylike dreams, rapid (saccadic) eye movements, and paralysis of nearly all skeletal muscles, except the muscle of respiration. Narcolepsy is also characterized by disordered regulation of rapid-eye-movement (REM) sleep.

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In contrast to people with disorders such as obstructive sleep apnea who have poor-quality sleep, those with narcolepsy usually feel refreshed after a full night’s sleep or a brief nap, but their sleepiness returns 1 to 2 hours later, especially when they are sedentary. Although it may appear to be challenging to distinguish daytime sleepiness due to narcolepsy from that caused by insufficient sleep, especially in teenagers, people with narcolepsy are sleepy every day, even with adequate nighttime sleep. Quite often, the diagnosis is made only after serious problems have arisen, such as declining grades at school, poor performance at work, or a motor vehicle accident. In many persons with narcolepsy, the sleepiness is severe, resulting in difficulty focusing and staying awake at school, at work, and during periods of inactivity (e.g., when watching a movie). Narcolepsy usually begins between the ages of 10 and 20 years with the sudden onset of persistent daytime sleepiness, although it can also develop gradually.

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