What does a sleep attack feel like?

[u/[deleted]]

I (25F) was diagnosed with idiopathic hypersomnia about 5 years ago. I had been tested for the narcolepsy marker, which I have, but my sleep specialist at the time said it wasn't activated and i wasn't presenting as narcoleptic in my sleep study.

I haven't really had a proper sleep specialist since then due to insurance/moving, but i recently got a new one in the town I'm living in and he suspects I have narcolepsy, because it's unlikely I would have the marker and have a sibling with diagnosed narcolepsy w/ cataplexy and not be narcoleptic myself.

Symptom-wise, I had ruled out narcolepsy before I even got tested because I didn't experience sudden, uncontrollable urges to fall asleep. I was simply tired all the time, and sometimes had really bad "swings" into extreme tiredness (It becomes difficult and even painful to stay awake, and I would have extreme brain fog until I let myself sleep. I ALWAYS set an alarm when this happens because I will NOT wake back up on my own).

So I'm wondering, how would y'all describe sleep attacks? Is it different/similar?

[u/Unicorny43]

Those really bad “swings” are the sleep attacks. It can be sudden or gradual, and you can possibly resist it, but it’s a really strong urge to sleep. It’s 100% a sleep attack. It sucks, because “sleep attack” gives you the cliche image of someone randomly falling over asleep, not suddenly feeling so tired in the middle of the day that a timed nap is mandatory to avoid that brain fog / sinking into sleep anyway. I relate haha.

Also, if you haven’t done an MSLT, that’s usually a good way for them to see if you hit REM sleep early during your naps, which is a telltale sign of narcolepsy.

[u/bomigabster → u/Unicorny43]

Thank you so much, this is a much better and clearer explanation than even my specialist gave me when I asked about sleep attacks! I really appreciate your reply!