Narcolepsy and Sleep

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but symptoms can be alleviated to the point of near-normal functioning in many patients. Treatment for narcolepsy includes the use of medication as well as behavioral therapy.

Behavioral therapies may help control symptoms, including taking three or more scheduled naps throughout the day. Patients should also avoid heavy meals and alcohol, which can disturb or induce sleep.

Counseling is very important for people with narcolepsy. The particular symptoms of this disorder are not widely understood by the general public and this may cause patients to feel uncomfortable, alienated, or depressed. The disease can also be quite frightening and the fear of falling asleep inappropriately often significantly alters life for people with narcolepsy.

In treating narcolepsy, doctors typically prescribe stimulants to improve alertness and diminish excessive daytime sleepiness. Antidepressants are also often used to treat cataplexy, hypnagogic hallucinations and sleep paralysis. Finally, sodium oxybate, a strong sleep-inducing agent, may be given at night to improve disturbed nocturnal sleep and reduce daytime sleepiness and cataplexy. All these treatments may have side effects. Stimulants can cause headaches, irritability, mood changes, nervousness, insomnia, anorexia, and irregular heartbeat. Side effects from the use of antidepressants vary and can include nausea, weight gain, anxiety or decreased emotions, drowsiness, sexual dysfunction and changes in blood pressure. Sodium oxybate can induce nausea, excessive sedation, mood changes and enuresis.

The goal in using medications to treat narcolepsy is to achieve normal alertness with minimal side effects.

COPING:

Behavior treatment of narcolepsy includes:

  • Several short daily naps (10-15 minutes) to combat excessive sleepiness
  • Establish a routine sleep schedule
  • Maintain a regular exercise and meal schedule
  • Avoid alcohol, caffeine, nicotine

Reviewed by Emmanuel Mignot, MD, PhD.