medical treatement
Many different drugs are used to treat the symptoms of narcolepsy, but not all are licensed for use in treating narcolepsy, and the evidence for their effectiveness in treating the disease is not always strong.
doping
If necessary, your GP or specialist may prescribe a medicine called a stimulant, such as modafinil, pitolisan, sodium oxybate or soriafiltol.
These drugs stimulate your central nervous system and help you stay awake during the day. They are usually taken as tablets every morning.
Common side effects of stimulants include:
- Headache
- nausea
- nervous
- Difficulty sleeping at night (insomnia)
- Stomachache
- irritability
- lose weight
If you experience persistent or bothersome side effects while taking stimulants, talk to your GP or specialist. They may be able to prescribe alternative medications.
Modafinil
Modafinil has been associated with irregular heartbeats and increased blood pressure, so regular monitoring is needed during treatment to check for these problems.
Modafinil should not be taken during pregnancy because it may cause harm to an unborn child.
Therefore, it is not safe to become pregnant while taking modafinil. Effective contraceptive measures should be used during taking and for at least 2 months after stopping taking the medicine.
If you are taking birth control pills, modafinil may make them less effective. Therefore, consider switching to a different type of contraceptive, or using another contraceptive along with your birth control pill. Your GP or specialist can help you decide.
sodium oxybate
Sodium oxybate is a drug that can improve sudden loss of muscle control and help you sleep at night, which can also reduce daytime drowsiness. But many areas are yet to receive NHS funding.
Sodium oxybate is a liquid medicine that you take in two doses at night: the first when you go to bed and the second 2.5 to 4 hours later.
You may need to use an alarm clock to make sure you take your medicine at the right time.
You need to take sodium oxybate 2 to 3 hours after a meal because food affects how much medicine is absorbed into the body.
Do not drink alcohol while taking sodium oxybate. You should also avoid activities that require mental alertness, such as driving or operating heavy machinery, until at least 6 hours after taking it.
Common side effects of sodium oxybate include:
- nausea
- Dizziness
- Headache
- diarrhea
- bedwetting
- Vomit
- lose weight
- blurry vision
- anxiety
- frustrated
If you are taking sodium oxybate and have persistent or bothersome side effects, tell your GP or specialist.
antidepressants
Although there is some uncertainty about the effectiveness of antidepressant medications in treating narcolepsy, they are sometimes used to treat symptoms such as sudden loss of muscle control, hallucinations, and sleep paralysis.
Many different types of antidepressant medications have been used to treat people with narcolepsy, including:
- Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and paroxetine
- Serotonin norepinephrine reuptake inhibitor (SNRI), such as venlafaxine
- Tricyclic antidepressants (TCAs), such as imipramine and clomipramine
These drugs work by changing the levels of certain chemicals in the brain and reducing the amount of dreaming (REM) sleep that is responsible for many of the symptoms of narcolepsy.
The side effects you may experience depend on the specific medication you take, but general side effects of antidepressant medications may include:
- Feeling irritable, shaky, or anxious
- Nausea
- Dry mouth_
- Slightly blurred vision
- constipate
- Dizziness
- drowsiness
- Sleep problems (insomnia)
- Sexual dysfunction, such as erectile dysfunction or difficulty reaching orgasm
Most side effects will improve within a few weeks. If you have any particularly bothersome or persistent side effects, please speak to your GP or specialist.
You should not stop taking antidepressants suddenly as you may experience unpleasant withdrawal reactions.
If you want to stop taking the medicine, your GP will gradually reduce your dose over a few weeks.
General treatment
good sleeping habits
To reduce excessive daytime sleepiness and make it easier to fall asleep at night, you can do the following:
- Frequent, short naps – nap evenly throughout the day; your GP or sleep specialist can help you plan a schedule that fits your other activities
- Stick to a strict bedtime - go to bed and wake up at the same time every day if possible
- Relax before bed - such as taking a hot bath
- Make sure you have a good sleeping environment—for example, keep your bedroom a comfortable temperature, quiet, and free of distractions
- Avoid caffeine (found in coffee, tea, and some carbonated drinks), alcohol, and smoking before bed
- Don’t exercise too close to bedtime – leave at least 2 hours between finishing exercise and going to bed
- Don’t eat a big meal before going to bed
Some medications you buy from the pharmacy, such as cold and allergy medicines, may cause drowsiness as a side effect.
If you have narcolepsy, you should avoid taking these types of medications during the day, as they may make your daytime sleepiness worse.
If you are not sure which medicines cause drowsiness, talk to your GP or pharmacist. They may be able to recommend non-drowsy alternatives.
talk to others
Narcolepsy is not only difficult to live with, it can also be difficult for others to understand.
Some symptoms, such as a sudden loss of muscle control (cataplexy), can be scary to people who don't understand the condition.
You may find it helpful to talk about your condition with your friends and family.
If your child is diagnosed with narcolepsy, tell your child's teacher. Teachers must understand what's going on with their children so they don't mistake their children's behavior for laziness or staying up too late.
If you have narcolepsy, there is no reason why you can't work as long as your employer understands your condition and agrees to accommodations, such as allowing you flexible working hours or planned naps. But some careers aren't right for you.
You may also find it useful to contact a local or national narcolepsy support group (such as Narcolepsy UK).
They will be able to offer advice about living with narcolepsy and help you connect with others in similar situations.
