No. While treatment can help manage symptoms and promote overall health, there is currently no cure for narcolepsy.
Imagine collapsing to the ground while giggling or falling asleep during a conversation. If you have narcolepsy, those unexpected behaviors may be common. But, surprisingly, as many as 10 years may pass before a person realizes they have narcolepsy or a healthcare professional diagnoses it. One of the best ways to treat it is to know the symptoms. Currently, one of the best ways to treat narcolepsy symptoms is to determine if there is an underlying curable medical condition causing them, such as a thyroid disorder, an alcohol addiction or other substance use disorder.
Narcolepsy Treatment Options
Narcolepsy treatment can begin with treating the following four symptoms:
- Excessive daytime sleepiness (EDS)
- Cataplexy (collapsing or near collapsing due to fear, laughter or crying)
- Strange hallucinations that occur as a person falls asleep or wakes up
- Sleep paralysis
Narcolepsy treatment options can include sleep hygiene, medication management, behavioral modification, counseling and exercise.
Proper sleep schedules are important, and patients improve if they regularly sleep for seven and a half to eight hours per night. Routine or scheduled daytime naps help, too. Additionally, regular exercise and other physical activities should be planned. Assessment and counseling about family stressors, trauma, depression, and alcohol or drug use can help in the management of narcolepsy.
Pharmacologic treatment of narcolepsy may include central nervous system (CNS) stimulants that are effective in 65 to 85 percent of people. These stimulants improve focus and wakefulness due to their effect on the brain’s neurotransmitter dopamine. Excessive daytime sleepiness can be relieved with methylphenidate (Ritalin), in doses as low as 5 mg per day. Numerous clinical trials demonstrate it as effective for narcolepsy treatment. Side effects may include headaches, stomach upset, jitteriness and reduced nighttime sleep.
Modafinil (Provigil) is a wake-promoting agent with an unknown mechanism of action and does not affect sleep time or REM sleep like other stimulants. Armodafinil (brand name Nuvigil) is like modafinil and helps EDS, except with fewer side effects. Methamphetamine may also be used for narcolepsy treatment, in some rare cases. Amphetamines are similar to methamphetamine and may be effective in treating excessive daytime sleepiness.
Sodium oxybate (brand name Xyrem) is approved to treat cataplexy by the Food and Drug Administration (FDA). Xyrem also treats EDS, improves sleep time and prevents nocturnal awakenings. It is considered a central nervous system depressant and has the potential for recreational abuse. To prevent Xyrem misuse, centralized pharmacies dispense the medication by prescription only.
If a person is tolerant of stimulant drugs, relief of narcolepsy symptoms may be found with the use of codeine. The only FDA-approved drug for narcolepsy treatment in children, pemoline, was removed from the market in 2005 due to concerns over liver toxicity. Pediatricians generally use generic methylphenidate and modafinil for children ages 6 through 15.
Natural cures for narcolepsy include:
- Guarana, which is a natural stimulant
- Cayenne pepper
- Ginkgo biloba, which increases blood flow to the brain
- Ephedra, which increases energy levels
- Gotu kola, which reduces fatigue
- Rosemary tea
- B complex vitamins, which are important in the sleep-wake cycle
- Eating complex carbohydrates and vegetables
- Avoiding eating simple carbs and sugars
- Eating proteins with carbohydrates to keep blood glucose levels steady and reduce sleepiness after meals
Diet and activity ideas for managing narcolepsy include:
- Avoiding heavy meals
- Avoiding drinking alcohol
- Taking short naps
- Exercising regularly
- Not operating machines, cars or other hazardous activities when drowsy
- Not swimming alone
- Wearing a life-preserver during water activities and boating
- Educating family and friends about cataplexy
Recent advances in narcolepsy research focus on treatments to prevent the loss of hypocretin from nerves. Narcolepsy cure research is being developed to target the autoimmune mechanism of hypocretin loss that causes narcolepsy. Intravenous antibodies or immunoglobulins that block the body’s destruction of its cells and tissues are being studied, as well as gene therapy.
Medical researchers at the University of Texas Southwestern Medical Center recently studied a compound called YNT-185 that binds strongly to the orexin receptor to produce hypocretin, which is the nerve protein in the brain that is lost in narcolepsy. It isn’t strong enough to be worthy of a clinical trial, but another candidate has been found that is 1000 times more potent than YNT-185. Additional narcolepsy cure research will likely focus on stem cells to regenerate lost brain cells. Stem cell research is gaining a foothold in all areas of therapeutic medicine.
Even though there is currently no narcolepsy cure, the long-term prognosis for people with narcolepsy is excellent, especially when diagnosed early. Pediatricians, neurologists and sleep specialists are essential in developing a plan of care, managing and monitoring medications and reducing adverse side effects. Support groups and counseling on lifestyle choices can add to the overall health and well-being of people with narcolepsy.
How to Manage Narcolepsy
The key to managing narcolepsy starts with an accurate diagnosis and eliminating the possibility of other treatable conditions. Narcolepsy management isn’t a cure but is essential to living a long, interactive and accident-free life.
Managing narcolepsy is possible with activities such as:
- Researching narcolepsy
- Using medication therapy for symptoms
- Eating high-protein, low-carb diets
- Engaging in social activities
- Exercising regularly
- Maintaining personal and professional schedules
- Napping frequently
- Avoiding triggers
- Enrolling in counseling
- Participating in support groups
Prioritizing your mental and physical health are key components of managing narcolepsy and other disorders. If you or a loved one struggle with a drug or alcohol addiction and co-occurring narcolepsy, The Recovery Village can help. Call today to learn more about treatment programs for substance use disorder and co-occurring mental health conditions.
Vendrame M, Havaligi N, Matadeen-Ali C, Adams R, Kothare SV. “Narcolepsy in children: a single-center clinical experience.” NCBI, May 2008. Accessed March 8, 2019.
Yoko Irukayama-Tomobe, et. al. “Nonpeptide orexin type-2 receptor agonist ameliorates narcolepsy-cataplexy symptoms in mouse models.” University of Texas Southwestern Medical Center, May 30, 2017. Accessed March 8, 2019.
Rogers AE, Aldrich MS, Lin X. “A comparison of three different sleep schedules for reducing daytime sleepiness in narcolepsy.”NCBI, June 15, 2001. Accessed March 8, 2019.
Benbadis, SR. “Effective treatment of narcolepsy with codeine in a patient receiving hemodialysis.” NCBI, June 16, 1996. Accessed March 8, 2019.
Morgenthaler TI, et al. “Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin.” NCBI, December 30, 2007. Accessed March 8, 2019.
Fry, JM. “Treatment modalities for narcolepsy.” ResearchGate, February, 1998. Accessed March 8, 2019.
NCBI. “Randomized trial of modafinil as a treatment for the excessive daytime somnolence of narcolepsy.” March 14, 2000. Accessed March 8, 2019.
Lockrane B, Bhatia P, Gore R. “Successful treatment of narcolepsy and cataplexy: A review.” NCBI, June 12, 2005. Accessed March 8, 2019.
Black J, Pardi D, Hornfeldt CS, Inhaber N. “The nightly use of sodium oxybate is associated with a reduction in nocturnal sleep disruption: a double-blind, placebo-controlled study in patients with narcolepsy.” NCBI, December 15, 2010. Accessed March 8, 2019.
“Narcolepsy: Developing New Treatments.” Division of Sleep Medicine at Harvard Medical School, February 21, 2008. Accessed March 8, 2019.
“Pemoline removed from US Market.” Formulary Watch, November 1, 2005. Accessed March 8, 2019.
Schlander, Michael. “Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) on prescription drug spending for children and adolescents: increasing relevance of health economic evidence.” NCBI, November 15, 2007. Accessed March 8, 2019.