Introduction

Cataplexy may have the following characteristics:

• Most attacks last less than 30 seconds and can be missed by even skilled observers. However, on severe cases, a person may fall and remain paralyzed for as long as several minutes.
• Typically the patient's head will suddenly fall forward, the jaw becomes slack, and the knees will buckle.
• Speech may become suddenly loud or broken and stutter-like.

Other Symptoms of Narcolepsy

Atonia. Atonia is a sense of paralysis that occurs between wakefulness and sleep, usually upon waking or sometimes at the onset of sleep. The person is conscious but cannot speak, move (cannot even open the eyes), and cannot breathe deeply. Atonia rarely lasts beyond 20 minutes, but when it first occurs, this experience can be terrifying, particularly if the patient also develops hallucinations.

Hypnagogic Hallucinations. Hypnagogic hallucinations are dreams that intrude on wakefulness, which can cause visual, auditory, or touchable sensations. They occur between waking and sleeping, usually at the onset of sleep, and can also occur about 30 seconds after a cataplectic attack.

• Visual hallucinations have been described as a "film running through the head" or as a waking dream with strong emotional content. Images can be intrusive. More commonly they may involve seeing colored forms that shift in size and shape.
• Auditory hallucinations may include random sounds or elaborate melodies.
• A person may also hallucinate feelings of rubbing or light touches, even levitation.

Such symptoms may also appear in other sleep disorders and are probably related to extreme sleepiness. In general, cataplexy must also be present for a clear diagnosis of narcolepsy. Some experts believe, however, that some patients with narcolepsy may experience hypnagogic hallucinations and daytime sleepiness and not cataplexy.

Microsleep and Automatic Behavior. In some cases, patients have so-called microsleep episodes, in which they behave automatically without conscious awareness. Such automatic behavior may not be recognized as part of a disorder by either patients or the people around them. Some examples include: