Both types of narcolepsy have the same treatment options, which focus on treating five main symptoms:
- excessive daytime sleepiness (EDS)
- When you feel sleepy or wake up, you can have hallucinations caused by sudden muscle weakness. This is called cataplexy.
- I can’t sleep at night, and I wake up many times.
It’s important to know that people with narcolepsy may also have other sleep disorders, like obstructive sleep apnea, that can make them sleepy during the day. It is often best to treat these conditions first and then work on making narcolepsy’s sleepiness better.
Narcolepsy treatments include:
- medication management
- lifestyle changes
- behavioral modification
The most common ways to treat narcolepsy fall into two categories:
Medications, pharmacologic treatments, like central nervous system stimulants, and other medications to cure specific symptoms of narcolepsy. Behavioral approaches concentrate on lifestyle changes and life routines to improve sleep quality and decrease the risk of other emotional challenges.
Medication for narcolepsy
Medication can’t cure narcolepsy but it can help you deal with its effects. The National Institute for Neurological Disorders and Strokes (NINDS) says that most people with narcolepsy can control their excessive sleepiness and cataplexy by changing their behavior and taking medicine.
To treat EDS and sleep attacks.
Every day, people with narcolepsy have EDS. Medication can’t cure EDS, but it can help keep serious accidents from happening. At the moment, four medicines can be used to help with EDS symptoms:
- Modafinil and armodafinil. The FDA has approved these treatments for EDS in narcolepsy and other sleep disorders. They work in the brain’s hypothalamus to keep you awake and stop you from falling asleep. Also, compared to traditional stimulants, these substances that make you wake up have fewer side effects and are less likely to make you addicted.
- Stimulants. Some stimulants, like amphetamine or methylphenidate, can help keep you awake and stop you from falling asleep. But stimulants may not help with cataplexy. They also have side effects and can be abused.
- Reuptake inhibitors for both norepinephrine and dopamine (NDRI). One example of an NDRI is solriamfetol. The FDA okayed it in 2019. It has the same side effects as modafinil and is a good choice for treating EDS in narcolepsy.
- Histamine receptor H3 (H3) agonist. Pitolisant is one of the newest drugs in this group. The FDA okayed it in 2019. It has been shown to help people with similar type 1 and type 2 narcolepsy with EDS and cataplexy.
- Sodium oxybate. The FDA has approved this treatment. This site covers both EDS and cataplexy. However, its use is limited because of safety concerns, such as depression of the central nervous system and abuse.
Fixing sleep problems at night
People with narcolepsy often have trouble sleeping at night. This is called disrupted nighttime sleep, or DNS. There aren’t many medicines that the FDA has approved to treat symptoms of trouble sleeping at night. You usually sleep the same amount in 24 hours as someone who doesn’t have narcolepsy. This is because you often sleep for shorter amounts of time during the day and night.
People with narcolepsy may sleep better overall if they take benzodiazepines or non-benzodiazepines that make them sleepy. But there is some early research on how these drugs affect people. Also, sodium oxybate has been shown to help people sleep better at night.
In addition to medicines, different behavioral techniques can help treat narcolepsy. These ways of living can assist you in sleeping better at night and being more alert during the day. You can try these non-medical ways to deal with the problem, changing them to fit your lifestyle:
- Planned naps. Planning short naps of 15 to 20 minutes can support you stay awake during the day. People with narcolepsy are much more likely to wake up feeling refreshed after a short sleep because they can get to REM sleep quicker than those without narcolepsy. Planned naps can be very helpful before actions that require a high level of alertness, like driving.
- Good sleep hygiene. Most people with types 1 and 2 of narcolepsy don’t sleep well at night. Most people don’t have trouble falling asleep, but waking up often can cause sleep fragmentation, which lowers sleep quality. Good sleep hygiene means keeping a regular sleep-wake cycle, avoiding alcohol and caffeine before bed, and making your bedroom a place to relax.
- Cognitive-behavioral therapy (CBT). CBT can help people with narcolepsy deal with depression and too much sleep. According to research in 2014, CBT for narcolepsy can help you stick to your medication schedule and ensure you get a good night’s sleep. CBT may help with sleep attacks, cataplexy, hypnagogic hallucinations, rest paralysis, and staying awake over time.
It can be hard to live with narcolepsy. Simple changes to how you sleep and live can help you deal with your symptoms and lessen their effect on your daily life. Consider these good sleeping habits to help you feel less sleepy during the day and get a deeper, more restful sleep at night:
- Do the same things every night before bed. Try going to bed and acquiring up at a similar time every day, even on the weekends.
- Create a relaxing routine for going to bed. This could mean taking a warm bath or shower, meditating, or using aromatherapy to help you calm down before bed.
- Ensure a good night’s sleep. Keep your room warmer, don’t let lights or sounds distract you, and try to go to bed in a completely dark room.
- Avoid psychoactive drugs before bedtime. Caffeine, liquor, and smoking are all examples.
- Try not to work out too near to your bedtime. Try to give yourself at least two hours between running out and sleeping.
- Eat small meals in the evening. Eating a big or heavy meal right before bed can keep your digestive system busy while trying to sleep, which could wake you up during the middle of the night.
Keeping a sleep log or journal might also help. Your sleep log tells you when you go to bed, how long it brings to fall asleep, how you sleep, and when you wake up in the morning. Sharing this information with your physician can help them better comprehend your sleep-wake cycles and alertness or drowsiness, allowing for more precise treatment.