How Doctors Help People With Narcolepsy Treat and Manage Their Symptoms

It is a sleep and chronic neurological disorder. The brain cannot control the ability to sleep or stay awake anytime during the day.

A patient can face difficulty driving, working, and doing physical activities like going to school. Narcolepsy can get dangerous for individuals carrying out day-to-day activities.

The national institute of neurological disorder and stroke said that a patient with narcolepsy lose control of muscle or anytime fall asleep while doing an activity.

Most times, narcolepsy patients can get sudden sleep attacks and cataplectic attacks. It can cause a sudden loss of control of the muscle.

The medical fraternity is yet to find a cure for narcolepsy. The chronic disorder stays with the patients for a long, does not go away, and worsens with time.

Types of Narcolepsy

Patients have two narcolepsy types - NT1 and NT2.

Type 1 Narcolepsy (NT1)

It is a form that frequently involves the symptom of cataplexy (abrupt and brief loss of muscle control) during consciousness. It affects 20% of cases of narcolepsy in patients.

Type 2 Narcolepsy (NT2)

This form does not involve the symptom of cataplexy, and 80% of narcolepsy patients, in most cases, have narcolepsy type 2.

Four Major Narcolepsy Symptoms

Patients may have one or more of these symptoms at any time. But they may not have all four symptoms at the same time.

Feeling Sleepy Excessively During Daytime

Also described by health specialists as a sleep attack, all narcolepsy patients have this symptom.

Feeling Weakness in Muscles Abruptly

The patients have mild-to-moderate effects on one side of the body or may feel light muscle weakness.

Hallucinations Related to Sleep

Patients may experience hallucinations during sleep, right after falling asleep, and before waking up.

Sleep Paralysis

It affects you fully or partially when you wake up. It is not always the case with narcolepsy patients. When it happens, you cannot move.

Treatment of Narcolepsy and its Types

The disruptive health condition responds well to medications and behavioural treatments with lifestyle changes. Doctors’ supervision, precaution, and care help you manage your condition and adapt to the effects.

To help patients improve their alertness and mitigate the risk of falling asleep during the daytime, some medications doctors may suggest with behavioural treatment.

2-pronged Narcolepsy Treatment

Specialists of narcolepsy implement two approaches to treat and manage narcolepsy in patients.

Behavioural or Lifestyle Change

It involves changes in your lifestyle and behavioural patterns involving daily habits to manage symptoms and mitigate the possibility of the physical and emotional burden.

The behavioural and lifestyle change approach includes −

• Plan your sleep and nap times

• Practice to sound sleep

• Maintain consistent bedtime & wake time

• Stop using alcohol and sedatives

• Stop using caffeine and caffeinated drinks

• Create & promote a sleep-friendly bedroom

• Avoid distractions from extraneous factors before bedtime

• Avoid complex activities that require acute attention and precision

• Find and keep support options when engaging in physical activities

• Promote health-friendly diet

• Exercise regularly for at least 30 minutes

• Stop smoking and stay away from smokers

Medications

Prescribed over-the-counter drugs to treat symptoms of narcolepsy are called pharmacotherapy.

To address narcolepsy, doctors begin with a prescription for one drug first. As a patient, you may have more than one prescription from your doctor to treat multiple symptoms.

Doctors may alter the dose and timings to suit the response to the medication and preferences.

Please note that the drugs used must be with a prescription and may contain side effects. Consult a doctor before the administration of any narcolepsy drugs.

Medications Prescribed to Address Symptoms of

Wake Fullness Drugs to Reduce Excessive Daytime Sleepiness

Doctors can mitigate the tendency of EDS and excessive sleepiness during the daytime. They prescribe wakefulness-promoting medications. It helps patients to stay alert and focused during daily activities.

Modafinil (trade name Provigil) & Armodafinil wakefulness-promoting medications are the first lines of treatment. These drugs stimulate your nervous system and lower the severity of daytime sleepiness frequency.

Solriamfetol (Trade name Sunosi) is used to manage narcolepsy. It is dual-acting dopamine. It helps patients to maintain wakefulness for a longer time.

Serotonine-noradrenaline reuptake inhibitors, such as Venlafaxine (Trade name Effexor), and tricyclic antidepressants, such as Clomipramine, also treat narcolepsy effectively.

Other wakefulness-stimulant Drugs

Methylphenidate, trade names are Aptensio XR, Concerta, Cotempla XR-ODT, Daytrana, Metadata ER, Methylin, QuilliChew ER, Quillivant XR, Ritalin, and Ritalin LA.

These drugs lower excessive daytime sleepiness and help promote alertness, focus, and awareness.

Treat Night Sleep Disruption

Narcolepsy may impair sleep ability and also a fragment of sleep. Sodium oxybate promotes undisrupted sleep and lowers the frequency of cataplexy.

Doctors often prescribe this as a treatment for narcolepsy type 1. It improves sleep during the night, mitigates cataplexy, and promotes EDS.

Cataplexy Treatment Medications

Patients with type 1 narcolepsy experience episodes of cataplexy. Patients lose full or partial muscle control briefly (a few seconds to minutes).

Sodium oxybate is effective in treating cataplexy. But beware of the side effects of the drug. It improves night sleep and EDS if well-tolerated with treating cataplexy.

Pitolisant (trade name Wakix) is also effective in promoting wakefulness and beneficial to patients with cataplexy.

Doctors prescribe antidepressants to treat cataplexy, such as Anafranil, Tofranil, SSRI (selective serotonin reuptake inhibitor) drugs, such as Fluoxetine (Prozac) & Paroxetine to lower the cataplexy frequency in patients.

Conclusion

Narcolepsy is not curable. However, you can treat and manage it well. The treatment aims to mitigate the risk and the symptoms and ensure the patient is safe doing physical activities, specifically in the daytime.

Doctors tailor the treatment depending on the age, medical history, health check-up report, symptoms, and treatment preferences to optimize for the specific patient.