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Narcolepsy Treatments

(Also Known As: Insomnia Treatments, Narcoleptic Treatments)

(Reviewed by: Paul Peterson, Licensed Therapist)

What Kinds of Narcolepsy Treatments are Available?

The treatment for narcolepsy will vary according to the symptoms and associated disorders that come with the condition:

Lifestyle Treatment

This is treatment approach that works for mild cases of narcolepsy. This form of treatment includes completing three or more sleep time schedules throughout the day, preferably a combination of a nighttime sleep with two 15-minute naps. Narcoleptics are also advised not to eat heavy meals and drink alcohol that can be factors in interfering with sleep. It is believed that mild narcolepsy that does not require medication can be corrected and helped by maintaining alertness with sleep scheduling. The benefits of sleep scheduling however are not clear with narcoleptics who require medications for their condition. 7

Pharmacology

The use of medication for narcolepsy aims to target the major narcoleptic symptoms of sleepiness and cataplexy. 8 There are two specific drugs that are approved by the FDA that are now considered to be the first line of drug treatment for narcolepsy:

  • Modafinil (drug treatment for excessive day time sleepiness)
    • This drug is the first line of drug choice for all types of sleeping disorders. Its mechanism of action involves keeping a narcoleptic awake and alert during the day and reduces the involuntary sleep episodes by 25%.
    • The drug does not affect the natural sleep hormones and it does not interfere with the voluntary naps of narcoleptics during the day.
    • The effects of the drug does not cause the same degree of anxiety and rebound effects that other stimulants do, with less potential for substance abuse.
    • Side effects include diarrhea, dry mouth, nausea, headache, nasal/throat congestion, dizziness, anxiety, nervousness, sleep difficulty, back pain and decreased hormonal effects of birth control pills.
  • Sodium Oxybate (Xyrem) for the treatment of narcolepsy
    • This drug reduces the cataplexy attack frequency and also helps in improving day time sleepiness. The significant benefit is usually obtained in 4 weeks with its peak in 8 weeks.
    • The prescription of the use of this drug, however, consists of a tight restriction owing to its potential for substance abuse.
    • Mild side effects include urine leakage, nausea, dizziness, sleepwalking, and headache. Serious side effects include coma, respiratory arrest, seizures, and death when given in high doses.

Other Drugs

  • Antidepressants
    • This group of drugs is prescribed to help suppress REM sleep and to reduce the cataplexy symptoms, sleep paralysis, and hallucinations.
    • Medications of this group that are often prescribed for narcolepsy include imipramine Tofranil), selective serotonin reuptake inhibitors (Prozac, Sarafem Zoloft), and protriptyline (Vivactil).
  • Stimulants
    • This group of drugs acts to stimulate the central nervous system to help a narcoleptic stay awake during the day. Medications prescribed include Modafinil (Provigil), methylphenidate (Ritalin) and other amphetamines.
    • Common side effects include palpitation, nervousness and can be highly addictive.

Sleep Hygeine 9

  • Maintain a regular sleep schedule.
  • Scheduled naps
  • Avoid heavy meals and alcohol
  • Restrict from driving when sleepy
  • Encourage children to participate in stimulating activities and sports after school.
  • Request school personnel to excuse the child from activities when feeling drowsy.

Counseling and Support Group

Because the symptoms of narcolepsy, specifically cataplexy and extreme daytime sleepiness, can disrupt a narcoleptic’s ability to live a normal life, the condition can often encourage the occurrence of anxiety and depressive disorders. A narcoleptic can possibly develop fear of falling asleep. Counseling can provide a supportive treatment among narcoleptics such as helping them cope with their condition. Support groups can also contribute to the coping ability of a narcoleptic knowing they are not alone to have this kind of sleeping disorder.

Could You Have Narcolepsy?

Narcolepsy Topics

Related Conditions

Dyssomnia – Difficulty Remaining Asleep, Disturbed Quantity and Quality of Sleep
Hypersomnia – Excessive Daytime Sleepiness, Prolonged Nighttime Sleep, Repeated Daytime Naps
Parasomnias NOS – Abnormal Movement When Sleeping, Abnormal Emotion and Behavior During Sleep, Sleepwalking, Bruxism, Sleep Terror Disorder, Nightmare Disorder