How to Treat Narcolepsy

Three Parts:Getting Medical TreatmentMaking Lifestyle ChangesStaying Safe

Narcolepsy is a neurological disorder that affects the brain's ability to normally regulate your natural sleep/wake cycle. The condition is characterized by sudden sleep attacks, insomnia, dream-like hallucinations, and sleep paralysis. Narcolepsy affects both men and women and although is not life-threatening, it can dramatically impact the life of a person with the condition.[1] There is no cure for the condition, but by getting medical treatment and adjusting your lifestyle, you can treat and manage the symptoms of narcolepsy.[2] Talk to your doctor to see which stimulant is best for your case of narcolepsy.

Part 1
Getting Medical Treatment

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    Talk to your doctor. If you have narcolepsy or suspect that you could suffer from the condition, it’s important to speak to your doctor about treatment. They can help determine the severity and formulate a plan to best tackle your symptoms.
    • Be open and honest with your doctor about your symptoms, including anything that makes them better or worse. Tell your doctor about any medications you are taking that could be causing narcolepsy or may interact with treatment options.[3]
    • Accurate diagnosis is important and there are other conditions that can affect sleep. You will likely need a sleep evaluation to make the diagnosis. In the meantime, there are strategies to improve you sleep/wake cycle.
    • See your doctor if your narcolepsy isn’t responding to treatment.
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    Take stimulants to stay awake. Stimulants are drugs that stimulate the central nervous system and can help people stay awake. These are the primary type of drugs given to people suffering from narcolepsy.[4]
    • Start with drugs such as modafinil or armodafinil. These are not as addictive as older stimulants and also don’t cause highs and lows often associated with stimulants. It’s uncommon to have side effects with modafinil or armodafinil, but you may get a headache, have nausea or a dry mouth.
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    Suppress REM sleep with SSRIs. Narcolepsy disrupts the REM cycle of sleep, which can cause symptoms like hallucinations and sleep paralysis. Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs), which are antidepressants, can suppress REM sleep and help manage your symptoms.[5]
    • Talk to your doctor about the best medication for you. Your doctor may prescribe fluoxetine or venlafaxine for you. These medications can cause weight gain, sexual dysfunction, and digestive problems. You may have to try a couple of different medications to find one that works best for you.
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    Manage cataplexy with tricyclic antidepressants. Cataplexy, which is a sudden and temporary loss of voluntary muscular function caused by an emotional trigger like laughter, is a common symptom in narcoleptics.[6] In addition to SSRIs, a older category of antidepressants called tricyclic antidepressants (TCAs) are an effective therapy for narcolepsy-induced cataplexy.[7]
    • Talk to your doctor about trying TCAs if you suffer from bouts of cataplexy and other anti-depressants don’t work. The doctor may prescribe protriptyline, imipramine, or clomipramine. These medications can cause side effects including dry mouth and lightheadedness.
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    Try sodium oxybate. Another medication that is highly effective for cataplexy is sodium oxybate, or Xyrem.[8] It also can improve nighttime sleep and control daytime sleepiness. Be aware that sodium oxybate can have side effects including nausea, bed-wetting, and sleepwalking. If you’re using it in conjunction with other medications, pain relievers, or alcohol, it can cause difficulty breathing, coma, or even death.[9]
    • Sodium oxybate is specific to cataplexy and is not widely available in the US.
    • Talk to your doctor or pharmacist about any concerns you have with sodium oxybate. If your symptoms get worse or you have other potentially serious side effects, contact your doctor as soon as possible.

Part 2
Making Lifestyle Changes

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    Keep a regular sleep schedule. If you suffer from narcolepsy, it’s very important to maintain a strict nighttime schedule. By going to sleep and waking up at the same time every day, you can effectively reduce even debilitating symptoms of narcolepsy.[10]
    • Go to bed and wake up at the same time every day, making sure that you get at least seven hours of sleep. Make sure that you stay on your schedule during the weekends or you may have more noticeable symptoms. If you have to change your schedule for any reason, consider adding naps during the day to prevent flare ups of symptoms.
    • Keep your bedroom for sleeping and avoid other activities such as reading or watching TV. These can interfere with your normal sleep patterns.
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    Take short naps. If you suffer from narcolepsy symptoms during the day, it’s a good idea to schedule short, regular naps during your drowsiest times of the day. Not only can a 20 minute nap refresh you, it can also decrease sleepiness for one to three hours.[11]
    • Keep your naps at 20 minutes or less because they are generally more effective than longer naps of an hour or more. Because every person is different, experiment with how long you nap to figure out the best amount of sleep for your symptoms.
    • Plan your naps at strategic times, which can prevent unplanned lapses into sleep. You can either take them at regular intervals, such as every three hours, or just before you have a big event such as a test or meeting.[12]
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    Have a healthy diet. Consuming a regular, healthy nutrient-rich diet based around the five food groups can help control symptoms of narcolepsy. Eating light or vegetarian meals during the day and staying away from heavy meals before important activities may prevent lapses into sleep or drowsiness.[13]
    • Choose foods from the five food groups — which are fruits, vegetables, grains, proteins, and dairy. Vary what you eat every day so that you get a range of nutrients.[14]
    • Eat whole fruits and vegetables such as blueberries, strawberries, cauliflower and spinach.
    • Try whole grain pasta, bread, steel cut oatmeal, brown rice or cereal for your grains.
    • Your protein should come from lean cuts of meat such as pork or poultry as well as cooked beans, peanut butter, or eggs.
    • You can get dairy from foods including yogurt, cheese, milks, and ice cream.
    • Avoid unhealthy food choices as much as possible. Processed and fried foods, sugary snacks, and desserts can weigh you down and make your symptoms worse.[15]
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    Exercise regularly. Getting moderate, regular exercise can help you feel more awake during the day. It also promotes better sleep at night. Daily activity also improves your mood, which is helpful to someone suffering from the emotional difficulties of narcolepsy.[16]
    • Get at least 150 minutes of moderate activity every week, which means about 30 minutes five days a week. If your symptoms are severe, consider doing two to three workouts of 15 minutes each. Do activities like walking, jogging, biking, or swimming. You may want to try yoga or Pilates which are forms of exercise that can also help relax you.

Part 3
Staying Safe

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    Stay away from substances that lead to drowsiness. Things like nicotine and alcohol and some over-the counter medications can act as stimulants and not only exacerbate your symptoms, but also disrupt sleep. Avoiding them as much as possible may help you more effectively manage your narcolepsy.[17]
    • Avoid drinking caffeine and alcohol as much as you can, especially close to bedtime. You should also limit nicotine consumption or give it up altogether. These substances can act as stimulants and may disrupt normal sleep patterns.
    • Avoid over-the-counter drugs that can cause drowsiness such as allergy and cold medications. Talk to your doctor about alternatives that won’t make your narcolepsy symptoms worse.[18]
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    Break up tasks. If you have a lot to do during the day, try breaking up tasks or jobs into manageable parts. This can help you minimize symptoms and prevent unplanned lapses into sleep.[19]
    • Focus on one small task at a time. When you’re finished, ask yourself if you can do another small task or if you need to rest for a few minutes before tackling the next activity.
    • Consider recording important conversations and meetings. If fall asleep or have any other symptoms, you can go back to these to ensure you don’t miss anything.
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    Manage stress and emotions. Intense emotions and stress can trigger the symptoms of narcolepsy. You can manage them by avoiding stressful situations and practicing relaxation techniques like deep breathing.[20]
    • Organize a flexible schedule for yourself that builds in time for naps and to relax from potentially stressful situations. Stay away from stressful situations as much as you can. If you can’t, take deep breaths and don’t react, which can make the symptoms of narcolepsy worse.
    • Get regular massages to help yourself relax. You can even give yourself mini-massages during the day as a way to release stress and tension. For example, rubbing your temples and neck can do a lot to relax you.
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    Inform other people. Many people suffer from narcolepsy and it’s nothing about which you need to feel ashamed. Let employers, coworkers, family members and friends know about your narcolepsy. This can alert them to help you if you lapse into sleep, hallucinations or other symptoms.[21]
    • Let people you inform know the best way to help you. For example, you could say, “If I fall asleep, don’t wake me up. I’ll get up within a few minutes and it would be a huge help to me if you could let me know what I missed.”
    • Wear a med-alert bracelet to inform others of your condition, especially in cases you don’t know the people.
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    Avoid potentially dangerous activities. If you are prone to sudden sleep attacks, don’t do any activity that would be dangerous if you had one. Driving, climbing ladders, or operating heavy machinery can be dangerous if you fall asleep, become immobile or are unable to talk. If you can’t avoid these activities, take a nap before doing them to manage any possible sleepiness.[22]


  • The exact cause of narcolepsy is still not known, but new research indicates it may be autoimmune-related.[23]

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Categories: Neurological Disorders