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The other symptoms may begin alone or in combination months or years after the onset of the daytime naps. There are wide variations in the development, severity, and order of appearance of cataplexy, sleep paralysis, and hypnagogic hallucinations in individuals. Only about 20 to 25 percent of people with narcolepsy experience all four symptoms.
These symptoms are usually accompanied by intense emotions such as fear and panic. [7] People also have sensations of being dragged out of bed or of flying, numbness, and feelings of electric tingles or vibrations running through their body. [8] Sleep paralysis may include hallucinations, such as an intruding presence or dark figure in the room.
Horsnell’s experience with narcolepsy hallucinations, however, is quite different. ... Since his symptoms started at age 12, Horsnell saw a pediatrician, an internist and four psychiatrists ...
The diagnosis of narcolepsy and cataplexy is usually made by symptom presentation. Presenting with the tetrad of symptoms (excessive daytime sleepiness, sleep-onset paralysis, hypnagogic hallucinations, and cataplexy symptoms) is strong evidence of the diagnosis of narcolepsy.
They are differentiated between hypnagogic hallucination, that occur at sleep onset, and hypnapompic hallucinations, which occur at the transition of sleep to awakening. [2] Although normal individuals have reported nocturnal hallucinations, they are more frequent in comorbidity with other sleep disorders, e.g. narcolepsy. [1] [2] [39]
Many of which present with similar symptoms such as excessive daytime sleepiness, which, in the absence of volitional sleep deprivation, "is almost inevitably caused by an identifiable and treatable sleep disorder", such as sleep apnea, narcolepsy, idiopathic hypersomnia, Kleine–Levin syndrome, menstrual-related hypersomnia, idiopathic ...
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