Information from family members may aid in assessing daytime functioning were naps taken, how many, were there nocturnal awakenings, were there observable restless legs, or a tiredness so extreme as to fall asleep while eating, talking on the telephone or, most frightening, while operating machinery or vehicles. Narcolepsy affects more than 200,000 people in the U.S. and may have a genetic basis. If you suspect narcolepsy, look for the presence of the narcolepsy tetrad. The last three indicators of the tetrad, are variably present. At least 50 percent describe cataplexy of some degree, although it may occur only two to three times in a life span.
Smaller percentages report the hypnogogic hallucinations and sleep paralysis.
Two other common sleep disorders, periodic limb movement and its cousin, restless leg syndrome, may lead your patients to early arousal from REM sleep and difficulty in achieving a quality sleep state. Once any of these sleep diseases is diagnosed, medication or medical equipment may be researched and prescribed. When quality REM sleep once again is attained it has been found patients may even go into REM rebound long periods of REM sleep that is restorative. As the days and weeks go by, most return to normal REM sleep stages and attain proper sleep architecture. Please remember, your patients complaints of excessive daytime sleepiness may be an important warning.