There is no cure for narcolepsy, but lifestyle can improve and medications can provide symptom control. Narcolepsy treatment is symptomatic. Therapies for this disorder involve the practice to obtain sufficient nocturnal sleep, good sleep hygiene and drug treatment. Proper sleep hygiene, which includes a change of sleep, avoiding alcohol and work, is extremely important. Sleep hygiene is also very important. For example, many people improve their symptoms if they maintain a regular sleep schedule, usually seven to eight hours of sleep per night.
Scheduled NAP during the day also helps. Studies suggest that the optimal sleep pattern is a combination of scheduled sleep at night (from 11:00 to 7:30) and 2-15 minute NAP. Since the disease has no cure, medication and lifestyle changes can help managing the symptoms. Narcolepsy treatment also include medication as stimulants, antidepressants and a drug called sodium oxybate.
Patients will be taught how to avoid stressful situations, strong emotions, in order to avoid the appearance of cataplexy, avoid drinking alcohol, to use of the car with utmost care and caution and only after their doctor’s approval.
Thus, from the therapeutic arsenal against sleepiness, the most efficient are the stimuli of the central nervous system. Although they were used a lot in the past, now become obsolete because of very high risk of addiction. Their only use for the time being, in adults is for the narcolepsy treatment.
Methylphenidate, for example, is a psychostimulant, especially given for the attention deficits in narcolepsy. In this case, methylphenidate is effective in increasing the state of vigilance and performance. The side effects are insomnia and nervousness. To mention, avoid simultaneous administration with cyclic antidepressants or monoamine oxidase inhibitors. If the effect is not the expected one, methylphenidate can be substituted with dextroamphetamine or methamphetamine, which can cause immediate effects as euphoria, increased energy, insomnia, tremors, increased libido, but also the risk of addiction is high.
A new popular narcolepsy treatment is a stimulant substance modafinil, it is used in all forms of excessive sleepiness, combating the generally fatigue. As a result, patients feel invigorated, have a positive attitude and feel themselves full of life and energy. Modafinil is generally a good substance, tolerated and more effective in some patients with narcolepsy. Moreover, it shows no significant psychiatric and cardiovascular side effects.
Treatment of cataplexy, sleep paralysis and hypnagogic hallucinations require administration of antidepressants, namely from 2 classes. The first class is represented by tricyclic antidepressants (of which protriptyline and clomipramine) and SSRIs, selective serotonin reuptake inhibitor such as fluoxetine (indicated in depression, in tiredness, sleep disturbances, etc.) .The second category is the sertraline, known to have fewer side effects than tricyclic antidepressants. The most important of the side effects are the anticholinergic ones manifested by dry mouth, blurred vision, constipation, etc.
Lifestyle modifications are important in keeping under control the symptoms of narcolepsy. Here are some tips:
- Adopt a daily schedule that will not warp. Go to bed at the same time every day, wake up early in the morning at the same hour, including weekends;
- Pull a nap. Schedule your little time in which to sleep during the day. A nap of 20 minutes at some point of the of day can be relaxing and can reduce sleepiness for the next few hours;
- Avoid alcohol and nicotine. Using these substances, especially at night, may worsen manifestations of narcolepsy and lower the effect of the narcolepsy treatment.
- Exercise regularly. Moderate exercises performed regularly with 4-5 hours before going to bed at night can provide lowering the day sleepiness and a better quality and quantity of sleep during the night.