Behavioral and Non-pharmacological Management of Narcolepsy

Abstract

Narcolepsy symptoms such as excessive daytime sleepiness (EDS), sleep attacks, and cataplexy have been shown to have significant impact on quality of life in this patient population. While pharmacotherapy is the first line of therapy, practically all patients with narcolepsy utilize some non-pharmacological strategy to manage symptoms of narcolepsy and practitioners commonly recommend such strategies as adjunct treatments. While these non-pharmacological approaches are commonly used and recommended, there are not yet any specific clinical recommendations or guidelines. Nonetheless, existing research provides some evidence indicating that non-pharmacological approaches may be useful for improving symptoms of narcolepsy. Napping approaches have received most research attention with benefits found on improving daytime sleepiness, alertness, and performance. However, the results across studies are not consistent and recommendations of optimal timing and duration of nap schedules remain undetermined. Dietary approaches received some limited attention and this review highlights the importance of diet and weight concerns in this population. Few studies assessed other strategies (e.g., extended nighttime sleep, temperature manipulations) and such approaches require further exploration. Taken together, research to date is encouraging and supports further investigation of non-pharmacological treatments in the management of narcolepsy.