If you or your child has narcolepsy, developing a management plan in collaboration with a sleep expert is critical for many reasons. At The Insomnia and Sleep Institute of Arizona, we work with patients as young as two years old to improve sleep disorders—and quality of life. Recently, Sleep Review produced a podcast featuring a sleep expert who provided tips on creating such a plan. Narcolepsy often requires pharmacological therapy in order to control symptoms. This is often coupled with lifestyle changes including controlled daytime naps. There needs to be a balance between enjoying the benefits of medications with the consideration of safety.
Depression and anxiety are common co-morbidities of many sleep disorders, including narcolepsy. Since it is much more common (and easier) to be diagnosed with such disorders, many patients seeking help with narcolepsy may already be on medications for anxiety and/or depression, including SSRIs and SNRIs. However, some narcolepsy medications may have side effects that trigger or exacerbate anxiety or depression. A reputable sleep doctor will consider which underlying medical problems may already be present when diagnosing and treating narcolepsy. They will talk to patients about potential future problems related to cardiovascular disease and obesity, both common co-morbidities of narcolepsy. These conditions, such as obesity, are observational data but still important because treating narcolepsy requires a chronic, long-term approach. Ultimately, a sleep doctor wants to know who you are, your co-morbidities, and how narcolepsy medications might affect those co-morbidities.
A Plan for Narcolepsy
According to the podcast, narcolepsy patients see a sleep doctor for two reasons: they don’t feel good and they want to feel better. Understandably, many narcolepsy patients are sleepy. They often also present with certain bedtime-related conditions such as sleep paralysis, vivid dreams, and even hallucinations. When you don’t get enough sleep, this also affects your daytime hours. Narcolepsy patients are routinely struggling with cognitive and executive functioning, thinking, productivity, mood, and social as well as work interactions. Sleep doctors will ask you how your excessive sleepiness is bothering you in order to determine how they can help.
Nobody wants to be sick and they certainly don’t want to die prematurely, which is why co-morbidities should always be taken into account. In many cases, narcolepsy and some co-morbidities are going to require a lifetime of care and management. Your sleep doctor will be working towards preventing other problems from developing based on the sleep condition diagnosed. This means they might talk to you about lifestyle and potential changes including diet, exercise, and of course sleep. It’s common to have a discussion on lowering sodium intake if a patient has hypertension, which is a common co-morbidity with narcolepsy and obesity.
After all, the best thing for sleepiness is sleep and that’s exactly what narcolepsy patients are struggling with. Your doctor will help you to understand how the brain controls sleep and wakefulness—and how these can better fit into your life. It’s a matter of orientation about the circadian process.
You and Narcolepsy
Many patients rely on referrals from their primary physician, which means information might get lost in the mix. The podcast guest stresses that it’s important not to just prescribe medication and say “see you later.” It is a must to see patients on an ongoing basis for monitoring. They need to keep an eye on your weight, how much you exercise, and may require metabolic studies or testing of blood sugar levels. Patients should be well managed over a long period of time. On average, patients using less aggressive medications should be seen every 6 months, but those on more aggressive meds should be seen every 3 – 4 months.
Check-ups complement sleep lifestyle changes in narcolepsy management plans. Medications work better when taken at the right time, so understanding circadian processes and how the brain manages control centers for wakefulness and sleep is paramount—as is understanding how behavior influences the sleep/wake process. For instance, narcolepsy patients should avoid sleep inertia, and that will require understanding how to nap correctly. Appropriate naps and good sleep simply help medications work better.
To learn more about sleep management plans for all sleep disorders, contact The Insomnia and Sleep Institute today. Call the office during business hours or simply complete the online contact form for the quickest response.
