Non-pharmacologic treatments of narcolepsy

Narcolepsy is a disorder that affects 1 in 2,000 people and can have a significant impact on patients' overall daily functioning. Although pharmacological methods are considered the primary treatment for managing the symptoms of narcolepsy, behavioral methods play a large role in adjunctive treatment. Patients often have residual sleepiness that is not fully managed by pharmacological methods alone and may benefit from behavioral interventions. Excessive daytime sleepiness and cataplexy often interfere with time spent socializing with others as well as the patient's ability to effectively complete tasks at work and at home. These features may be disabling and can often lead to problems with employers, coworkers, family members and romantic partners. In addition, poor education regarding the disorder often leads to an inability to adequately cope with the symptoms. This chapter reviews behavioral approaches to the treatment of narcolepsy, including a brief review of literature and specific methods that can be applied. Strategies for the management of excessive daytime sleepiness, such as scheduled naps, the role of diet and exercise and planning of activities during times of optimal alertness, are discussed. The role of sleep hygiene and stimulus control in patients with narcolepsy is reviewed. This chapter elaborates upon the importance of psychosocial support, education, counseling and recognition of psychiatric and cognitive co-morbidities.