Men and women face different issues when it comes to sleep disorders, but one factor that is unique to women is pregnancy. What is the potential impact of narcolepsy on pregnancy, birth control, and breast feeding? At The Insomnia and Sleep Institute of Arizona, we offer unparalleled staffing levels and are proud to serve you as the Face of Sleep Medicine. We treat and manage all sleep disorders, including narcolepsy, and understand the concerns you might have if you struggle with narcolepsy and are also pregnant or considering starting a family.
If you have narcolepsy, it is important to know that none of the mainstream medications used to treat this sleep disorder are considered safe for pregnancy. There is also increasing research pointing towards some medications, such as modafinil, as being considered “unsafe.” What are your options if you’re thinking about becoming pregnant? You may be able to temporarily stop your narcolepsy medication under the guidance of your doctor. This may be recommended while you’re trying to conceive, during pregnancy, and throughout breastfeeding. However, while it is important to consider the risks of taking such medications during pregnancy, it is equally important to think about the risks of not taking these medications.
Narcolepsy symptoms can vary drastically. For some patients, it might be perfectly acceptable to stop medications for pregnancy. Others might face an unsafe level of daytime sleepiness if they were to stop medications. This is a conversation to have with your prescribing physician and sleep doctor. Those with severe cataplexy might not be able to safely drive, work, or maintain relationships without this medication, making stopping medication not an option for them.
Medication During Pregnancy
For those who find that medication is necessary during pregnancy, a close look at the risks of different medications will be required. You may need to switch narcolepsy medications, at least for the duration of the pregnancy and breastfeeding. Ideally, this conversation with your doctor will take place before conception, but it is never too late to ensure the best pregnancy experience possible for you and your baby. It is also ideal to take the lowest dose possible during pregnancy, or in some cases it might be recommended to take medication during the first trimester but not for the second and third trimesters.
It’s always a good idea to schedule a pre-conception consultation with all healthcare providers including your prescribing doctor, OBGYN, and sleep doctor. Overall, both OBGYNs and of course sleep experts have more experience and expertise when it comes to managing sleep disorder medications during pregnancy than general physicians. There is very limited information available about narcolepsy medication and breastfeeding, so this can be a tough decision to make. However, if you are safely able to stop medication during conception and/or pregnancy, it may make sense to continue medication-free through breastfeeding. Another option may be to choose formula feeding over breastfeeding so that you can return to your narcolepsy medication.
Narcolepsy and Oral Contraceptives
Birth control is, of course, an inherent part of the childbearing years for many people. It is known that popular narcolepsy medications like modafinil, pitolisant, and armodafinil all interact with hormonal birth control. This happen via cytochrome P450 3A4, with armodafinil and modafinil being major inducers, which means a quicker hormone therapy metabolism. In other words, if you are taking hormonal birth control, you face a higher contraception failure.
There is no one size fits all solution when it comes to narcolepsy and pregnancy (or birth control). The key is understanding how such medications may affect other Rx’s as well as your pregnancy journey. It is typically recommended that those interested in birth control, and who have narcolepsy, opt for a non-hormonal form of birth control such as a copper IUD. For those wanting to become pregnant and who have narcolepsy, making sure your sleep doctor is part of the journey is critical for your health and the safest pregnancy possible. To learn more, schedule a consultation with a sleep doctor today. Call The Insomnia and Sleep Institute during business hours or, for an even faster response, simply complete the online contact form right now.
