I’ve been wondering the same thing. I was diagnosed 21 years ago when I was 28. It took years to get to the diagnosis because my lack of cataplexy symptoms made it harder, in fact they tried to say I had epilepsy (absence seizures) despite my eeg showing abnormalities but not conclusively epilepsy. Sleep tests proved it was narcolepsy without a shadow of doubt.
I live in New Zealand and our medication options are very limited and personally I don’t find them very effective. I moved and lived in England for a couple of years and was on very different medication which was amazing I actually felt great and had few symptoms….until I started developing new ones! I would get sudden muscle weakness in my face when I laughed a lot or was watching sad movies or just experienced strong emotions. It got worse and my whole head just drops and my torso kinda twitches. I was very used to vivid dreaming tormenting my nights but twice while I was in England I got up from the bed and just dropped like a rag doll and couldn’t move momentarily.
I’m back living in nz again now and back on Ritalin and things are almost back to how they were before but I do still occasionally experience face weakness especially if I have had a build up of lost sleep. My head also nods and drops and struggle to control my movements if I get to excited or laugh a lot.
I can’t help wonder if those symptoms will continue to get worse or not. So far they haven’t.
It certainly doesn’t feel like a clear cut line to me