Narcolepsy and Excessive Daytime Sleepiness

  • Rafael Pelayo
  • Christian Guilleminault
Part of the Current Clinical Practice book series (CCP)


A patient with unexplained sleepiness or fatigue presenting in a primary care setting often poses both a diagnostic and therapeutic dilemma. The etiology of the sleepiness may not be readily apparent. The patient and the general public may be at risk of serious personal injury unless prompt treatment is initiated. The risk of injury creates for the practitioner significant medical and legal responsibilities. Of all the different causes of excessive daytime sleepiness, narcolepsy should always be considered. Historically, the word “narcolepsy” was first coined by Gélineau in 1880 to designate a pathological condition characterized by irresistible episodes of sleep of short duration recurring at close intervals. In the same paper, he wrote that attacks were sometimes accompanied by falls or “astasias.” In the 1930s, Daniels emphasized the association of cataplexy, hypnagogic hallucinations, sleep paralysis, and excessive daytime sleepiness. Calling these symptoms the “tetrad” of narcolepsy Yoss, Daly, and Vogel described sleep-onset rapid eye movement sleep (REM) in narcoleptic patients. In 1963, Rechtschaffen et al. reported sleep-onset REM periods in narcolepsy. Narcolepsy is a neurological syndrome that is characterized by abnormal sleep, including excessive daytime sleepiness often with disturbed nocturnal sleep and pathological manifestations of REM. The REM abnormalities include early REM during sleep onset and cataplexy. Cataplexy is an abrupt and reversible decrease or loss of muscle tone, most frequently elicited by emotion.


Obstructive Sleep Apnea Obstructive Sleep Apnea Syndrome Excessive Daytime Sleepiness Nocturnal Sleep Multiple Sleep Latency Test 
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Suggested Readings

  1. Utlely M. Narcolepsy: A Funny Disease that Is No Laughing Matter. Self Published, Desoto, TX, 1995.Google Scholar
  2. Kryger M, Roth T, Dement W. Principles and Practice of Sleep Medicine. W.B. Saunders, Philadelphia, 1994.Google Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Rafael Pelayo
  • Christian Guilleminault

There are no affiliations available

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