Narcolepsy is a sleep disorder that typically presents with extreme daytime sleepiness and oftentimes signs of REM dissociation. The technical term is “cataplexy” and it is one of the many sleep disorders treated at The Insomnia and Sleep Institute of Arizona. There are various treatment options including changes in sleep hygiene as well as “alerting agents.” With many medications available to help with narcolepsy, especially in extreme cases, there have also been countless studies on each of the drugs before they receive FDA approval. Recently, sodium oxybate and low-sodium oxybate (commonly known as the drug Xywav) has been used to help with narcolepsy symptoms. However, one recent sleep specialist reported that his 43-year-old female patient experienced an unusual side effect: mirth.
Mirth is defined as amusement or being on the verge of laughing, similar to what you experience with laughing gas. The patient had a genetic history of narcolepsy. She first saw her sleep doctor one year ago and had excessive daytime sleepiness but no other presentable sleep disorders, such as restless leg syndrome or sleep apnea. She underwent a sleep lab test and was diagnosed with narcolepsy type 2. Overall, her sleep pattern during her testing was “adequate” so she wanted to look into wake-promoting agents. She was prescribed Sunosi, which resulted in lingering sleepiness, so sodium oxybate was then prescribed. This was during the peak of the pandemic when she was working from home, so she decided to go off the meds. This led to an insurance issue and, when the issue was finally resolved, she was then prescribed Xywav for night use. It was at this time that she started to experience mirth.
Narcolepsy Drug Side Effects Worth a Laugh
Although the patient wasn’t bothered by this unusual side effect, she did try going off of it for a few days—but the excessive daytime sleepiness immediately resumed. She calls the side effect “pleasant” and is in no way associated with negative feelings. Additionally, she noted that the mirth lessened when she was eating. According to the patient, she denies that mirth is a problem and wanted to stay on this medication regimen because it not only helped her narcolepsy, but also led to a nice side effect. A number of other potential causes were investigated but none were found.
Typically, the drug makeup of magnesium, calcium, potassium, and sodium oxybate can be prescribed to treat cataplexy in those seven years and older. The safety of this combination has been studied in placebo-controlled, double-blind, randomized withdrawal studies. Studies show that the drug is overall tolerable, stable, and effective over a two-month period. However, studies have also shown no side effects of mirth. Instead, a few studies have shown that aggression and depression can occur with Xywav—clearly the opposite of this patient’s experience. She says she feels fine in the morning on the meds and her doctor suggests that the mirth might even help to encourage drug compliance.
Narcolepsy and You
This is an unusual case of side effects that are seemingly non-harmful and enjoyed by the patient. Drugs are often part of treating narcolepsy and other forms of severe cataplexy, but know that there are many choices available. It’s important to find a regimen that works for you and your lifestyles. Combining medications for narcolepsy with other changes such as sleep hygiene can help to amplify and sustain positive results. If you suspect you or your child has narcolepsy, it’s important to get help as soon as possible. Lack of quality sleep can negatively affect every part of a person’s life, especially in developing bodies. Narcolepsy can also be very dangerous, as being excessively tired during the daytime can lead to accidents.
Unfortunately, narcolepsy is a sleep disorder that has been manipulated by the media. If you are very tired during the day but think you got enough sleep, you may have a sleep disorder, such as narcolepsy or insomnia. To get the help you need and find out more, schedule a consultation with a sleep expert today. No referral is needed. Call The Insomnia and Sleep Institute or complete the online form right now.
