Doctors Answers (2)
Narcolepsy should first be verified by a nocturnal study followed by a daytime nap study. After that, if the diagnosis of narcolepsy is positive, then it should be managed by a physician. I am unable to suggest any "natural cures;" however, a board-certified sleep specialist can get you back on track after the diagnosis is confirmed. You should always exercise caution while driving.
Treatment of narcolepsy generally includes medication. Scheduled naps to reduce sleepiness and other behavioral approaches are helpful. These would include avoiding medications or other substances that can enhance sleepiness, avoiding triggers for cataplexy, if cataplexy is a component of the narcolepsy, and avoiding placing yourself in harm's way such, as driving while sleepy. As far as a cure is concerned, there is no cure, natural or otherwise. It is felt that there has been death of cells in the brain which excrete orexin (hypocretin), which promotes wakefulness. Today, we have no way to replace the cells or the orexin and have to depend on medication to treat the sleepiness and the cataplexy, if present. Most patients with narcolepsy who take stimulants report that they do not feel "wired" or have a feeling of stimulation with these medications. They just take enough to feel "normal" like everyone else. We find that narcolepsy patients rarely abuse stimulant medication. This only happens when they cannot obtain prescription medication to combat the sleepiness. Medications to enhance wakefulness are often complemented with medications to combat cataplexy. We think of cataplexy as an intrusion of REM sleep into the wake state creating muscle weakness. Therefore, medications which suppress REM sleep are often used. These would include many of the antidepressants, especially the SSRIs. There is only one medication approved by the FDA to treat both the sleepiness and the cataplexy associated with narcolepsy. That drug is sodium oxybate or better known as Xyrem. It is considered the standard of care for these symptoms in narcolepsy by the American Academy of Sleep Medicine. It is controlled, and when used according to directions is considered safe and usually very effective. Most patients who take Xyrem also take stimulants in the daytime for quality of life, and for their safety and the safety of others.
