Q. I get irresistible sleep attack during day time and sleep paralysis. What is the possible cause?

Hello doctor,

I have daily sleep attacks during the day (irresistible sleep attacks) and before I fall to sleep I see things like I am dreaming but I knew I am awake. At night, before I fall asleep I have multiple episodes of sleep paralysis. Sometimes in every morning, I have sleep attacks and I fall asleep and sometimes I have dreams but when I am awake I realize it has been only seconds or a few minutes.

It started last year. Initially, I was unable to stay awake beyond 10 PM, then I started to have multiple episodes of sleep attacks during the day. It started as an irresistible urge to sleep which I tried to resist but then I go into a hallucination where I see and hear things like a dream but I am aware that I am awake and when I realized that the sleep become more intense and I fall asleep. This episode lasts for 12-30 minutes and in between the episodes, I feel refreshed but only for a few minutes and then the next attack will start. At night, upon falling asleep I have sleep paralysis and it is usually once but two incidences happened for three consecutive times. It mostly happened when I am not doing activities, after meal, using phone, watching TV or when I am sitting in the car for long-distance. This been happening for a duration of four months and after that, it comes and go with no specific pattern.

I saw a doctor and my labs were all normal. I did a sleep study and MSLT and also normal and I do not have depression. What do you think is the possible cause of that?

Thank you doctor,

But I have one episode only of sleep attacks which was for four months and then disappear. I know I had such sleep attacks many years back but it was not like this. I have done a sleep study and MSLT and showed no abnormalities although I have done it when the sleep attacks have already disappeared.