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Patients with narcolepsy have periods of sudden sleep onset or paralysis caused by the abnormal onset of "rapid eye movement sleep" during waking hours. Narcolepsy is an inherited disease that usually manifests in early adulthood. Though not the most common cause for excessive daytime sleepiness, narcolepsy is a condition that has very important implications because of the specific therapies that are used in treating such patients and risks to the patient (below).

Patients that have this condition also have a phenomenon known as cataplexy, where muscles in the body suddenly become limp. This may occur either spontaneously or during periods of emotional upset or excitement. Patients may also complain of very vivid hallucinations either during the transition from wake to sleep or in the transition from sleep to wakefulness. Patients often have difficulty distinguishing their dreams from reality. Patients also may experience "sleep paralysis", where they may have between several seconds and one minute of inability to move their muscles upon awakening.

It is particularly important to identify this condition because of the dangers of driving or operating heavy machinery if untreated. The diagnosis of narcolepsy is made by a nocturnal polysomnogram that excludes other causes for daytime sleepiness and a multiple sleep latency test (MLST) that confirms the diagnosis of REM onset during daytime naps. In many states, patients with narcolepsy may not drive until they have been on adequate therapy, ideally under the guidance of a sleep specialist. Eventually, with adequate treatment, patients may be able to regain their ability to maintain alertness and safely drive again.

PCCAB has a dedicated web site related to our Sleep Services. Please click the link below to learn more about this division of our services.

Sleep Medicine Associates of Maryland

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