Narcolepsy And Lifestyle Changes

Introduction

Narcolepsy is a condition where your brain has lost the ability to maintain regular sleep patterns or sleep cycles. People with this condition find themselves struggling to stay awake during the day and consequently, fall asleep suddenly multiple times during the day. Individuals living with this condition also find themselves constantly waking up at night and therefore, having interrupted sleep. 

There are two types of narcolepsy:

Type 1: This occurs in people who have low levels of the chemical hypocretin-1 (which helps you to stay awake). People with this type of narcolepsy usually experience cataplexy. Cataplexy is the sudden muscle weakness that comes about as a result of intense emotions, usually positive emotions, such as excitement. This weakness can last anywhere from a few seconds to a few minutes.¹

Type 2: People with type 2 narcolepsy do not have low levels of hypocretin-1 and typically do not show signs of cataplexy. They usually experience less severe symptoms.

Signs and symptoms

People with narcolepsy usually start experiencing symptoms in their mid-teenage years or in their mid-thirties. Symptoms of narcolepsy typically remain constant and do not get progressively worse as you age.

Symptoms can include:²

• Disturbed night sleep
• Moderate to severe daytime sleepiness, which is a common initial symptom of the condition 
• Daytime sudden sleep attacks. These sleep attacks can happen at any time. They can last anywhere from just a few minutes to 30 minutes. These sleep attacks usually leave you feeling refreshed for a while 
• Sleep paralysis (not all people who experience sleep paralysis have narcolepsy)
• Cataplexy
• Hypnagogic hallucinations
• Rapid eye movement (REM) sleep 15 minutes into falling asleep, as opposed to this stage of sleep being observed 60 to 90 minutes after falling asleep
• Lack of focus and alertness

Children may present with slightly different symptoms, such as:²

• Inattentiveness
• Restlessness
• Motor overactivity
• Drop attacks, which are sudden falls without warning and without loss of consciousness
• Aggression
• Irritability

Lifestyle changes for managing narcolepsy

Importance of lifestyle changes for managing narcolepsy

Narcolepsy can have serious effects on your day-to-day life. The sudden sleep attacks during the day can really make it difficult to socialise, work, or complete everyday tasks. Additionally, not getting a good night's rest due to waking up constantly can also increase your stress levels and have a negative impact on your general well being.³

Although there is no cure for narcolepsy, with the right lifestyle changes, you can manage the symptoms well. 

Sleep hygiene

Establishing a regular sleep schedule

Create a daytime nap schedule

Set aside time during the day to take naps. These naps will be approximately 20 minutes each and it is best to schedule them for the times that you usually feel the most sleepy. These naps will leave you feeling refreshed and will hopefully reduce the frequency of drop attacks, making it easier to plan your day around them. 

Create a night time sleep schedule

Try and create a night bedtime routine where you go to sleep and wake up at the same time everyday. Before going to bed, doing something that you find relaxing, such as taking a bath or reading a book, can also help you sleep better.

Creating a comfortable sleep environment

Your sleep environment can have a significant impact on your quality of sleep. Try and make the area where you sleep as comfortable as possible. For example, make sure that you have comfortable bedding or that your room is not too hot or too cold. Finally, ensure that the room that you sleep in is dark. 

Avoiding caffeine, nicotine, and alcohol before bedtime

Refrain from smoking, drinking alcohol, or consuming caffeine a few hours before going to sleep. Caffeine and nicotine tend to make you feel more awake and therefore, you may struggle to fall asleep if you take them too close to your bedtime. Alcohol, on the other hand, can make you fall asleep quickly and you may wake up before you have had sufficient rest.⁴

Exercise and diet

Importance of regular exercise

Getting into the habit of exercising for at least 20 minutes a day can really benefit not just your sleep, but your overall health. Regular exercise can improve your sleep quality. However, try not to exercise too close to your bedtime as this may keep you up.

Healthy diet and its impact on narcolepsy

Good eating habits, such as not eating large meals just before going to bed, are important lifestyle changes that may make your quality of sleep much better. 

Maintaining a healthy weight

People with narcolepsy may be more prone to being overweight, which is a risk factor for diabetes. This may be due to several factors, such as having a slower metabolism due to lower levels of orexin in the body. Orexins are chemicals that contribute to how hungry and awake you feel, as well as your metabolism.⁵ 

However, if you find yourself falling into a routine of thinking poorly about your body and suddenly change your eating habits, speak to a healthcare professional as soon as possible to ensure that you do not develop body dysmorphia or eating disorders.

Stress management

Managing stress to prevent excessive daytime sleepiness

Managing your stress effectively can help you feel less exhausted. It may also help you fall asleep better at night as sometimes stress keeps us up.

Techniques for stress reduction

• Practice mindfulness and meditation
• Stretch and exercise regularly
• Avoid drugs and alcohol
• Surround yourself with a good support system

If you feel overwhelmed and continue to feel stressed even after trying the techniques mentioned, speak to your healthcare professionals who will be able to further assist you.

Medication adherence

Importance of taking medication as prescribed

People with narcolepsy usually get prescribed various medications. It is important to follow the instructions provided by your doctor with regards to when to take your medication and the prescribed dose in order to get the best results.

Potential medications you may be prescribed include:

• Modafinil
• Amphetamine-like stimulants that act like adrenaline (the body’s natural stimulant)
• Antidepressants
• Sodium oxybate
• Histamine 3 receptor antagonist

Potential side effects and management strategies

It is always good to familiarise yourself with the side effects of any medication that you have been prescribed. Side effects of medication are typically found on the box, but asking your doctor as well is a good idea. Where possible, try to stay away from medication that increases drowsiness.

Summary

Narcolepsy is a condition where the brain struggles to maintain regular sleep cycles. This results in daytime sleep attacks and interrupted sleep at night. Making the necessary lifestyle changes, such as sticking to a sleep schedule, taking regular daytime naps, and avoiding nicotine, alcohol and caffeine before bed, can help minimise the effects of your symptoms on your everyday life.