Can You Drive With Narcolepsy?

Can People With Narcolepsy Drive?

Having narcolepsy makes driving riskier, but many people with the disorder can obtain a personal driver’s license and still safely drive. People who have been diagnosed with narcolepsy are not allowed to have a commercial driver’s license, however . Commercial driving is especially risky for people with narcolepsy, because long, monotonous drives on a highway may make them more likely to fall asleep.

Experts advise that doctors speak with each person with narcolepsy about their individual driving ability and potential risks, as these can vary from person to person. There are tests, medications, and driving strategies that can make driving with narcolepsy safer.A doctor may advise a person with narcolepsy to avoid driving in certain situations Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source . For example, adolescents with narcolepsy are often told not to drive on highways or for long stretches of time. Others realize they are better off avoiding drives after dark or shortly after eating.

Is Driving With Narcolepsy Dangerous?

Over one-third of people with narcolepsy have had a car crash as the result of tiredness, a common narcolepsy symptom. Having narcolepsy makes a person three to four times more likely to get in a car crash compared to average. For these reasons, people with narcolepsy are ineligible to receive a commercial driver’s license.

That said, many people with narcolepsy are able to safely drive for personal reasons. Drowsy driving and cataplexy are the narcolepsy symptoms most likely to make driving risky. Learning how to navigate these risks may make driving safer for people with narcolepsy.

“Narcolepsy doesn’t always mean giving up the keys, but it does require a careful balance between independence and safety on the road.”

Dr. Dustin Cotliar

Sleep Medicine Physician, MD

Drowsy Driving

Excessive daytime sleepiness is a characteristic symptom of narcolepsy that can interfere with driving. People with narcolepsy may be so tired that they have a “sleep attack” and fall asleep unexpectedly during the daytime. Due to this tiredness, people with narcolepsy may find themselves falling asleep in situations that lack stimulation or feel boring. Often, long drives or drives on a highway put a person with narcolepsy at a greater risk of falling asleep while driving, due to their monotony.

Drowsiness also becomes stronger the longer a person with narcolepsy has remained awake. This is another reason drowsy driving is riskier on long drives. Napping before a drive or taking a break from a drive to nap may reduce the risk of falling asleep while driving.

Cataplexy

Sixty percent of people with narcolepsy also experience cataplexy, or sudden muscle weakness triggered by emotions. Often, cataplexy is triggered by laughing or feeling excited, but it can also be triggered by frustration or anger. If a person experiences cataplexy while driving, the symptom may increase their risk of a crash.

When cataplexy symptoms are severe, they can cause muscle weakness or even temporary paralysis in a person’s arms or legs. Although these symptoms usually resolve within two minutes, they could still interfere with a person’s ability to turn a steering wheel or step on the gas pedal or brake when needed.

Managing Risks & Driving Safely With Narcolepsy

There are multiple strategies available to help people with narcolepsy reduce their driving risks.

• Keep drives short: Short drives of about 30 minutes are likely safer for people with narcolepsy than long drives. People with narcolepsy may want to ask friends and family how long they can normally go without becoming tired when determining their driving limits, since they may not have awareness of it.
• Avoid highways: Highway drives are usually longer than local drives. Also, highway drives can be more monotonous, with less stimulation as the visual background remains the same. Avoiding highways could be a good strategy for some people with narcolepsy.
• Nap before driving: Since napping usually increases alertness in a person with narcolepsy, strategic napping may help with driving. Taking a short nap in the hour before a drive may help prevent excessive tiredness on the drive.
• Take nap breaks: If a person with narcolepsy must undergo a long drive, nap breaks may help by reducing sleepiness. For example, instead of driving for 1.5 hours straight, a person could drive for 45 minutes, pull over somewhere safe for a 20-minute nap break, then drive the remaining 45 minutes.
• Avoid substance use: Using substances like alcohol and cannabis may increase driving risks for people with narcolepsy. These and other sedating substances can also worsen sleep quality and potentially interact with narcolepsy medications, so they should be avoided altogether.
• Avoid driving after meals: Driving after meals, especially those containing simple sugars, may be a bad idea for some people with narcolepsy.
• Consume caffeine: Although it hasn’t been directly studied, some researchers suggest that consuming caffeine before or during a drive could potentially help a person with narcolepsy remain awake and alert while driving.
• Get enough sleep: Obtaining adequate restorative sleep at night is an important part of managing narcolepsy. Keeping narcolepsy well-managed overall may help reduce driving risks.

“Managing narcolepsy for safe driving is like crafting a personalized roadmap. It involves understanding your limits, careful planning, and sometimes taking the scenic route to ensure a safe journey.”

Dr. Dustin Cotliar

Sleep Medicine Physician, MD

Can Medication Help?

Most people with narcolepsy take a stimulant or wakefulness-promoting medication to help them maintain alertness during the day. A few studies have found that these medications can improve driving performance and reduce the risk of a car crash.

The side effects of stimulant and wakefulness-promoting medications vary depending on the drug. They may include anxiety, loss of appetite, dry mouth or palpitations. People with narcolepsy can discuss these medications with their doctor to determine what might be best for them.

Sometimes people with narcolepsy are prescribed a sleeping pill or antidepressant medication as treatment. While these medications may improve narcolepsy symptoms overall, their impact on driving safety in particular hasn’t been studied.