How is Narcolepsy Treated?

Narcolepsy is a rare sleep disorder, but there are a variety of options for treatment. Because of how narcolepsy impacts day to day activities, it’s incredibly important for safety and overall happiness to seek a solution to manage the disease. Although 200,000 Americans have the disease, even more, are impacted by the consequences of them not choosing to diagnose and treat the disorder. It can be dangerous and alarming when it goes undiagnosed. Here are some of the main options those with the disease have to manage the symptoms.

Option 1: Xyrem®

This drug is also known as sodium oxybate. It is used to treat the symptoms associated with Type 1 narcolepsy, which is excessive sleepiness with cataplexy. It is FDA approved to treat daytime sleepiness. Although primarily used for Type 1, it can also be used to treat Type 2, narcolepsy without cataplexy. Many like the versatility of this medication, but because of its potential to get misused, it can be difficult to get. A special order needs to be placed to ensure that it is getting used for the prescribed reasons. The medication acts as a tranquilizer which is great for making sure patients sleep all through the night without disrupting REM sleep.

Directions

Dr. Mostafavi, a respected leader and expert in sleep medicine states, “Start taking a small amount and gradually get up to maximum dosage. As you can tell from the name, this contains a high content of salt so if you have salt restrictions, you may not use this or it has to be used with caution. At night, this is taken in two doses – one prior to sleep and one in the middle of the night as it doesn’t have a long effectiveness.”

Option 2: Stimulants

Stimulants are known as a second line treatment1 for ESD (Excessive Sleep Disorders). The ones available or most recommended have been around since the late 1990s. The most commonly prescribed are Modafinil and Armodafinil.

Modafinil – A Brazilian study on this drug showed 66% of participants with marked improvement of symptoms and effectiveness of the medication. Its overall purpose is to improve daytime wakefulness.

Armodafinil – Studies2 with this drug have shown not only an improved amount of daytime alertness but also showed an overall improvement in memory, attention and fatigue.

Side Effects

While the effects of these are less extreme than Xyrem®, they may cause headaches or an allergic reaction in some users.

Option 3: Behavioral Strategies

Scheduled Naps

Some may be happy to hear the words “scheduled naps” when their doctors prescribe this. This is even more true to someone with narcolepsy who feels significantly tired. This method of treatment has been prescribed for many years. It helps to control the excessive tiredness by establishing a pattern for sleep, even if it’s during the day.

Directions

In order to get the best results, the naps should be short. It’s recommended to limit naps to about 15-20 minutes so that the ability to fall asleep at night is not impacted. The nap should be scheduled around a person’s most tired period in the day. Because it is doctor ordered, most employers will comply with this short break needed to maintain health and alertness.

If the one nap a day does not seem to improve symptoms, naps can be increased to different times of the day, but the length of the nap itself should stay the same. For example, one could be taken mid-morning, one around lunch time and another before a commute home from work in the afternoon.

It’s important to note that this is not typically the only method of treatment. It is best to have scheduled naps in conjunction with medication.

Practice Smart Sleep

Getting quality sleep is important for everyone. Those with a sleep disorder need to make an even more conscious effort to practice smart sleep habits in order to make the most out of each night. While there may not be a cure for narcolepsy, people can set themselves on the right track for sleep by following basic sleep tips.

• Limit Screen Time – The light from screens such as TV, phones or tablets can make it more difficult for the brain to recognize it is time for sleep. An hour before bed, turn off all electronic devices to wind down.
• Be Consistent – Our bodies like consistency. Even if it’s a weekend, try to stick to a schedule of bedtime and wake time.
• Avoid Caffeine – While avoiding caffeine would be the most ideal altogether, it’s not always feasible. Try to limit caffeine to one cup in the morning and nothing in the afternoon.

These are all great options to help control and manage narcolepsy. There is no cure for the condition, but advances are being made every day to help people manage these symptoms. Narcolepsy can greatly affect your quality of life without treatment. If you have recently been diagnosed and are looking for treatment options that are proven to help, contact us today.

1) New developments in the management of narcolepsy. Vivien C Abad, Christian Guilleminault

Nat Sci Sleep. 2017; 9: 39–57. Published online 2017 Mar 3. doi: 10.2147/NSS.S103467

2) The efficacy and safety of armodafinil as treatment for adults with excessive sleepiness associated with narcolepsy. Harsh JR, Hayduk R, Rosenberg R, Wesnes KA, Walsh JK, Arora S, Niebler GE, Roth T Curr Med Res Opin. 2006 Apr; 22(4):761-74.61-74.