Intended for US healthcare professionalsVisit Patient Site Full Prescribing Information Important Safety Information Sign Up

Contact Us »

Narcolepsy

Regularly Assess for EDS and Cataplexy in All Patients With Narcolepsy^1-3

Hailey Atkinson, MSN, FNP-BC

EDS may vary over time in patients with narcolepsy^4-6 and may manifest in different ways^7,8

Inability to stay awake and alert throughout the day⁷
Lapses in concentration^7,8
Patients may describe as “tiredness” or “fatigue”⁸
Constant need for sleep⁷
Unintended lapses into drowsiness or sleep⁷
Automatic behaviors associated with microsleep episodes (e.g., writing gibberish)^7,9

Cataplexy may develop years after the onset of EDS and may differ widely among patients^7,10

Drooping of the eyelids¹¹
Muscle weakness in the face or neck^7,11
Mouth opening or tongue sticking out¹¹
Facial jerks/grimaces¹¹
Knee buckling³
Patients may describe as “losing muscle control,” “clumsiness,” or loss of grip^2,3,10

Interactive cataplexy tool thumbnail

Assessing for cataplexy in patients with narcolepsy

Use this interactive tool to explore examples of cataplexy.

Download Symptom
Assessment Guide»Download Telemedicine
Best Practices»

References

Krahn LE, Hershner S, Loeding LD, et al. Quality measures for the care of patients with narcolepsy. J Clin Sleep Med. 2015;11(3):335.
Morse AM. Narcolepsy in children and adults: a guide to improved recognition, diagnosis and management. Med Sci. 2019;7(12):106.
Thorpy M, Morse AM. Reducing the clinical and socioeconomic burden of narcolepsy by earlier diagnosis and effective treatment. Sleep Med Clin. 2017;12(1):61-71.
Almeneessier AS, Alballa NS, Alsalman BH, Aleissi S, Olaish AH, BaHammam AS. A 10-year longitudinal observational study of cataplexy in a cohort of narcolepsy type 1 patients. Nat Sci Sleep. 2019;11:231-239.
Büchele F, Baumann CR, Poryazova R, Werth E, Valko PO. Remitting narcolepsy? Longitudinal observations in a hypocretin-deficient cohort. Sleep. 2018;41(9). doi:10.1093/sleep/zsy118
Kim T, Lee JH, Lee CS, Yoon IY. Different fates of excessive daytime sleepiness: survival analysis for remission. Acta Neurol Scand. 2016;134(1):35-41.
American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Text Revision. American Academy of Sleep Medicine; 2023.
Ahmed IM, Thorpy MJ. Clinical evaluation of the patient with excessive sleepiness. In: Thorpy MJ, Billiard M, eds. Sleepiness: Causes, Consequences and Treatment. Cambridge University Press; 2011:36-47.
Pizza F, Filardi M, Moresco M, et al. Excessive daytime sleepiness in narcolepsy and central nervous system hypersomnias. Sleep Breath. 2020;24(2):605-614.
Bassetti CLA, Adamantidis A, Burdakov D, et al. Narcolepsy - clinical spectrum, aetiopathophysiology, diagnosis and treatment. Nat Rev Neurol. 2019;15(9):519-539.
Pizza F, Antelmi E, Vandi S, et al. The distinguishing motor features of cataplexy: a study from video-recorded attacks. Sleep. 2018;41(5). doi: 10.1093/sleep/zsy026