Medication
For most people with narcolepsy, treatment involves both behavioral approaches and medications. A combination of therapies frequently decreases excessive daytime sleepiness but a recent survey finds that it doesn’t eliminate it completely in most patients 6.
Nutrition
Sunosi (solriamfetol) and pitolisant (Wakix) are newer stimulants used for narcolepsy, headache and anxiety. Pitolisant may also be helpful for cataplexy.
How is narcolepsy treated?
Specifically, cognitive behavioral therapy for narcolepsy (CBT-N) has increasingly been identified as an important supplement for treatment, and many features of narcolepsy (e.g., depression and hypersomnia) are already regularly treated with cognitive behavioral strategies.
What stimulants are used to treat narcolepsy?
Sleep hygiene involves reoccurring habits and behaviors that contribute to a high quality of sleep. Sodium oxybate, the only medication effective in treating most narcolepsy symptoms, works by improving the quality of nocturnal sleep16,20, indicating that higher sleep quality is vital for improving narcolepsy symptoms.
Can CBT-N help treat narcolepsy?
What is sleep hygiene and how does it help narcolepsy?
When was narcolepsy first discovered?
Although the nature and severity of symptoms experienced by an affected person may varying over time, the disorder is not progressive. Narcolepsy was first described in the medical literature in 1880 by Gelineau and in 1887 by Westphal.
What is the first line treatment for narcolepsy?
Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Doctors often try modafinil (Provigil) or armodafinil (Nuvigil) first for narcolepsy.
Where did narcolepsy come from?
Many cases of narcolepsy are thought to be caused by a lack of a brain chemical called hypocretin (also known as orexin), which regulates sleep. The deficiency is thought to be the result of the immune system mistakenly attacking parts of the brain that produce hypocretin.
Who first diagnosed narcolepsy?
History. Narcolepsy is the English form of the French word narcolepsie , and was first used in 1880 by the French physician Jean-Baptiste-Edouard Gélineau (1828-1906) [1].
Which treatment has been found to be an effective cure for narcolepsy?
Sodium oxybate It is the only medication proven effective, and is recommended by the FDA, for treating both EDS and cataplexy4.
Which commonly abused drug is used to treat narcolepsy?
Xyrem (sodium oxybate {GHB}) is a sedative that promotes sleep and used for the treatment of narcolepsy to help people sleep better at night and to reduce excessive daytime sleepiness and cataplexy.
How was narcolepsy first discovered?
The first convincing descriptions of narcolepsy-cataplexy were reported in Germany by Westphal (1877) (100) and Fisher (1878) (25). The unique association of episodes of muscle weakness triggered by excitement and sleepiness were described in these two reports.
Did Harriet Tubman have narcolepsy?
Early signs of her resistance to slavery and its abuses came at age twelve when she intervened to keep her master from beating an enslaved man who tried to escape. She was hit in the head with a two-pound weight, leaving her with a lifetime of severe headaches and narcolepsy.
Can Covid cause narcolepsy?
Taking these hypotheses into account, the main message of this review to sleep medicine clinicians and researches is to consider SARS-CoV2 infection as a possibly triggering event leading to narcolepsy.
When was narcolepsy named?
Narcolepsy was named by Gélineau (and cataplexy was named by Henneberg in 1916). The evidence in both cases is sufficiently convincing to conclude that they were likely each HLA-DQB1*0602 positive and hypocretin deficient.
What part of the brain controls narcolepsy?
The hypothalamus is a deep brain region just in front of the brainstem. It regulates arousal, sleep, hunger, body temperature, and other fundamental behaviors. The number of hypocretin-producing neurons in the brain is markedly reduced in the brains of people with narcolepsy.
Does narcolepsy lead to dementia?
The relationship between Narcolepsy and Lewy Body dementia is not well defined. It has been reported that hypocretin/orexin levels are low in those with Lewy-Body Dementia. Rarely has narcolepsy been reported as the presenting sign of Lewy Body Dementia.
What is the best medicine for narcolepsy?
Medications for narcolepsy include: Stimulants. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Doctors often try modafinil (Provigil) or armodafinil (Nuvigil) first for narcolepsy.
How to help someone with narcolepsy?
Stop for naps and exercise breaks whenever you feel drowsy. Don't drive if you feel too sleepy. Support groups and counseling can help you and your loved ones cope with narcolepsy. Ask your doctor to help you locate a group or qualified counselor in your area.
How to diagnose narcolepsy?
Methods of diagnosing narcolepsy and determining its severity include: Sleep history. Your doctor will ask you for a detailed sleep history. A part of the history involves filling out the Epworth Sleepiness Scale, which uses a series of short questions to gauge your degree of sleepiness.
What is the medication that suppresses REM sleep?
Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Doctors often prescribe these medications, which suppress REM sleep, to help alleviate the symptoms of cataplexy, hypnagogic hallucinations and sleep paralysis.
What is the test that measures the amount of time you sleep?
It measures periods of activity and rest and provides an indirect measure of how and when you sleep. Polysomnography. This test measures a variety of signals during sleep using electrodes placed on your scalp. For this test, you must spend a night at a medical facility.
Can narcolepsy cause rapid eye movement?
Specialists will observe your sleep patterns. People who have narcolepsy fall asleep easily and enter into rapid eye movement (REM) sleep quickly. These tests can also help doctors rule out other possible causes of your signs and symptoms.
Can narcolepsy cause drowsiness?
If you have other health problems, such as high blood pressure or diabetes, ask your doctor how the medications you take for your other conditions may interact with those taken for narcolepsy. Certain over-the-counter drugs, such as allergy and cold medications, can cause drowsiness.
What is the primary medical approach to narcolepsy?
Prescriptions. The primary medical approach to narcolepsy involves prescribed medication. Generally speaking, the specific drug indicated will depend on the specific symptoms that arise. These prescribed medications include the following.
How to treat narcolepsy?
Even if you’re taking medications for narcolepsy, lifestyle changes are essential in treating the condition. Helpful approaches include: 1 1 Getting daily exercise: Regular exercise has been shown to improve sleep quality and reduce the severity of some associated conditions. At a minimum, aim for at least 20 minutes of physical activity four to five hours before bedtime. 2 Taking naps: Taking short, regular daily naps at times of the day when you’re drowsiest can also help ease symptoms. 3 Avoiding alcohol and caffeine: Alcohol, a depressant, and caffeine, a stimulant, can both impact the quality of sleep. At the least, drinking should be avoided for several hours before you go to bed. 4 Skipping large meals: Large, heavy meals, if consumed right before bed, can also disrupt the quality of sleep. In turn, this can make symptoms worse, too. 5 Quitting smoking: Among the many health benefits of tobacco-smoking cessation, ditching this habit can improve sleep quality. 6 Having a regular sleep schedule: Maintaining regular sleeping habits—even on weekends or days off—is another approach that can help with narcolepsy. Make sure you get up and go to bed at the same times every day.
How many people have narcolepsy?
Occurring in about 1 in 2,000 people, narcolepsy is a neurological disorder characterized by bouts of intense daytime sleepiness, cataplexy (sudden loss of muscle control), visual hallucinations, and sleep paralysis, among other symptoms. 1.
What is the best medication for narcolepsy?
Provigil (modafinil) is the most commonly prescribed treatment for narcolepsy. This drug is particularly effective in taking on excessive daytime sleepiness. A stimulant first approved by the Food and Drug Administration (FDA) in 1999, it is a first-line treatment for this condition.
What antidepressants are effective against sleep paralysis?
Known to be effective against cataplexy, sleep paralysis, and hallucinations, two classes of antidepressants are employed—tricyclics and selective serotonin reuptake inhibitors (SSRIs). Of the tricyclics, Tofranil (imipramine), Norpramin (desipramine), and Anafranil (clomipramine), among others, are indicated.
Can silver bullets cure narcolepsy?
While there is no “silver bullet” that can eradicate narcolepsy, current medications, alongside lifestyle changes, can certainly help minimize this condition's impact. Today, doctors are better equipped than they’ve ever been to take it on, and the outlook will only improve as research continues.
Does narcolepsy require surgery?
While surgery for narcolepsy doesn’t exist, researchers have begun investigating non-pharmaceutical therapies. With narcolepsy cases having been linked to deficiencies of a neurotransmitter called hypocretin, potential approaches involve boosting these levels. Current work is focused on several techniques for doing so:
Who is the scientist who studied narcolepsy?
Other laboratories are developing methods to restore hypocretin signaling in the brain. Dr. Christian Burgess has worked at Harvard Medical School to unravel the neurobiology of narcolepsy. Over the past 10 years, researchers have made great advances in understanding the underlying biology of narcolepsy, and these insights are now leading ...
Does narcolepsy affect Gaba?
In general, drugs that increase GABA signaling are sedating, and research suggests that some people with narcolepsy have evidence of enhanced GABA signaling, though this is debated. 4 - 6 Clarithromycin, flumazenil, and pentylenetetrazole can block GABA receptors, and clinical trials are now underway to test the efficacy of these drugs.
Can narcolepsy be improved?
Research in animal models of narcolepsy suggests that excellent improvements in all symptoms could be obtained by restoring hypo cretin signaling. However, this is a challenge in clinical practice, as the hypocretins are relatively large molecules that cannot easily get into the brain.
Can narcolepsy be treated with stem cells?
Treatments for narcolepsy based on gene therapy or stem cells are exciting, as they could produce lasting improvements without the side effects of current medications. Much more research is needed before these can be developed into safe and effective treatments for people with narcolepsy.
Sleep Medicine and the Evolution of Contemporary Sleep Pharmacotherapy
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Abstract
Narcolepsy is a chronic, disabling sleep disorder with a significant diagnostic delay. Nowadays, treatment is focused on managing symptoms that impacts patient’s life, such as at workplace, social events or even at school, but not aimed cure the disease.
1. Introduction
Narcolepsy is a chronic and disabling disease, which, according to the International Classification of Sleep Disorders (ICSD-3), considered to be hypersomnias of central origin [ 1 ].
2. Existing lines of therapy
As we have already mentioned, current therapies are aimed at the symptomatic treatment of narcolepsy.
3. Summary
In recent years there has been a significant increase in new therapeutic options such as Pitolisant and Solriamfetol, aimed at developing better control of narcolepsy symptoms.
4. Future therapies
Administration of orexin peptides (ORXR2) as effective stimulants may also be of interest to decrease EDS in patients with NT2 and idiopathic hypersomnia and associated conditions with normal CSF ORX levels.
5. Conclusion
Recent years have seen a resurgence of new lines of therapy for the treatment of narcolepsy.
Medications for narcolepsy
Medications cannot cure narcolepsy, but they can help you manage your symptoms. According to the National Institute for Neurological Disorders and Stroke (NINDS), most people can manage the excessive sleepiness and cataplexy related to narcolepsy by using a combination of behavioral changes and medications.
Behavioral therapy
Along with medications, various behavioral techniques can help in narcolepsy treatment. These involve lifestyle strategies that help promote better nighttime sleep and daytime alertness.
Self-care
Living with narcolepsy can be challenging. Making simple changes to your sleep habits and lifestyle can help manage symptoms and minimize their impact on your daily life.
Next steps
Not only is narcolepsy a challenging condition to live with, but it can also be difficult for others to understand. Some of the symptoms can be frightening for people who are unaware of the condition.
Diagnosis
Treatment
Clinical Trials
Lifestyle and Home Remedies
Specialist to consult
Coping and Support
Preparing For Your Appointment
- There is no cure for narcolepsy, but medications and lifestyle modifications can help you manage the symptoms.
Home Remedies and Lifestyle
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Prescriptions
- Lifestyle modifications are important in managing the symptoms of narcolepsy. You may benefit from these steps: 1. Stick to a schedule.Go to sleep and wake up at the same time every day, including weekends. 2. Take naps.Schedule short naps at regular intervals during the day. Naps of 20 minutes at strategic times during the day may be refreshing an...
Specialist-Driven Procedures
- Dealing with narcolepsy can be challenging. Making adjustments in your daily schedule may help. Consider these tips: 1. Talk about it. Tell your employer or teachers about your condition and work with them to find ways to accommodate your needs. This may include taking naps during the day, breaking up monotonous tasks, recording meetings or classes, standing during meetings or lect…
A Word from Verywell
- You're likely to start by seeing your family doctor. However, in some cases when you call to set up an appointment, you may be referred to a sleep specialist. Here's some information to help you prepare for your appointment.