Amara, Mary Halsey Maddox, in Principles and Practice of Sleep Medicine (Sixth Edition), 2017 Sleep-Related Hallucinations 49 PLMS may be present during REM sleep, a feature uncommon in most patients with PLMS.Īmy W. Periodic leg movements in sleep (PLMS) are also common in narcolepsy. 48 If cataplexy is not present in a patient with OSA, narcolepsy may be suspected only if daytime sleepiness persists after adequate treatment of the sleep apnea. 4,47 Obstructive sleep apnea (OSA) is also not uncommon. Because the Hcrt system has affects on appetite, it is not surprising that some patients with N+C have an increased body-mass index. 46 In this disorder, skeletal muscle atonia is absent during REM sleep and dreams may be acted out. Patients with narcolepsy may also have the rapid eye movement sleep behavior disorder (RBD).

Aldrich 4 reported that the proportions of patients reporting automatic behavior were similar in groups of N+C and N–C patients. Inattentiveness related to drowsiness may occur. These episodes typically involve activities that are habitual or not demanding of skill. They may find themselves doing activities that make no sense like putting salt in iced tea. For example, patients report driving a car and not remembering the trip. Automatic behavior is defined as performing a seemingly purposeful task with no clear memory of having performed the activity. 1–4 Automatic behavior is present in up to 50% of patients. In general, N+C patients have more disturbed sleep than N–C patients. The amount of stage N1 sleep is increased. Narcolepsy patients often experience disturbed nighttime sleep with tossing and turning in bed, leg jerks, nightmares, and frequent awakenings. Berry MD, in Fundamentals of Sleep Medicine, 2012 Disturbed Nocturnal Sleep and Other Symptoms: N+C, N–CĪlthough HH/HPH, SP, and daytime sleepiness are the classic narcolepsy symptoms, patients often report other associated symptoms that can be significant (see Table 24–1).

Hypnogogic hallucination