Narcolepsy is a neurological condition that inhibits one's ability to control and regulate sleep-wake cycles. There is no known cure for narcolepsy, but there are a variety of treatments1 to alleviate and control the symptoms of narcolepsy. Many people can minimize the impact of narcolepsy symptoms on their day-to-day lives through a combination of medication and lifestyle changes.
There are several medications that can combat and help reduce the effects of narcolepsy. Typically, these medications fall into two categories: stimulants that promote alertness and wakefulness; and anti-depressants and sedatives that help ensure a more regulated sleep, treat cataplexy, and can decrease overall anxiety.
One of the most common pharmaceutical narcolepsy treatments is the use of central nervous system stimulants. One popular stimulant, modafinil, promotes wakefulness by increasing levels of dopamine in the brain. It is often the medication of choice because it has a lower risk of developing substance dependence than other stimulants, such as amphetamines.
Another medication that can be very effective in treating excessive daytime sleepiness and cataplexy is sodium oxybate. It is a powerful sedative that is taken at nighttime, often requiring two doses over the course of one night.2 It can take several weeks for the benefits of sodium oxybate to become apparent, and it is often used in conjunction with stimulants such as modafinil to optimize efficacy. However, because of its strength and potential side effects, sodium oxybate must be used with care.
Antidepressants are also often used to manage cataplexy. Antidepressants work by increasing norepinephrine and serotonin in the brain, which suppresses REM sleep. This can help reduce hallucinations, sleep paralysis, and even control cataplexy.
All of these medications should be taken under the instruction and guidance of a medical professional to determine the right set of treatments for each person.
Because narcolepsy is a chronic lifelong condition with a wide range of different symptoms and causes, it is important to seek medical help to determine the right combination of medication and lifestyle adjustments. Besides medications, there are several ways people can adapt their lifestyle to reduce the effects of narcolepsy. Some of the key lifestyle changes that can help alleviate symptoms are: creating a rigid sleep routine, taking scheduled naps, and avoiding stimulants before going to bed. For many people with narcolepsy, short naps taken at regulated times throughout the day can improve alertness for several hours afterwards, temporarily reducing feelings of tiredness and sleep deprivation.4 Taking naps earlier in the day can be restorative and invigorating without impeding the quality of nighttime sleep.
Eating a healthy diet and exercising regularly has also been known to reduce excessive daytime sleepiness. Exercise can help naturally tire out the body and so decrease the chances of trouble sleeping at night. For some, taking certain vitamins and dietary supplements can also help naturally reduce the intensity of the effects of narcolepsy.
Narcolepsy causes range widely and currently are not completely understood. However, for many people, one cause of narcolepsy is the lack of or having a low level of the brain chemical hypocretin. Everyone who has narcolepsy with cataplexy has lower levels of hypocretin. Narcolepsy can also be caused by genetic family history, an autoimmune disorder, or even a brain injury.5
Intense periods of emotion have been known to trigger narcolepsy or amplify symptoms. Some people with narcolepsy respond to these intense emotions by falling spontaneously asleep.
There are some lifestyle changes that can alleviate symptoms or help make them more manageable. Some methods include simple ways to improve sleep at night, like exercising during the day or avoiding caffeine, nicotine, or alcohol. Other key lifestyle changes that can help improve narcolepsy symptoms are making sure one has a regulated sleep schedule, takes naps, and creates a calming sleep environment.
It is very risky to drive an automobile with untreated narcolepsy as it increases the likelihood of getting into a serious accident. It is possible that with the right combination of treatment people with narcolepsy can drive with caution. It is best to discuss your limits and aptitude for driving with a healthcare professional.
Narcolepsy treatment differs for each person and there is no single medicine that works the same way for everyone. There are however certain medications that have proved very effective in managing narcolepsy. These include modafinil, ADHD medications such as ritalin, sodium oxybate, and some antidepressants. Medication is frequently a key component in finding a way to keep narcolepsy under control.
© 2021 American Sleep Association.