1. Excessive Daytime Sleepiness
Narcolepsy causes nighttime sleep to be choppy and fragmented, which causes you to feel sleepy during the day, says Andrew Varga, MD, an associate professor of medicine, pulmonary, critical care, and sleep medicine at the Icahn School of Medicine at Mount Sinai in New York City.
How It Can Affect You Because narcolepsy interferes with your sleep quality — not quantity — staying in bed for a few extra hours of shut-eye won’t fix the problem. “No matter how long you sleep, sleep quality is just poor, and sleeping longer won’t cure excessive daytime sleepiness,” Dr. Varga says.
Poor nighttime sleep can cause you to become so overwhelmed by the need to sleep that you may fall asleep during the day, whether you’re in class, in a meeting, or at your desk. This can have major ramifications in your ability to be successful in school or at work, as well as your ability to safely perform tasks such as driving a car.
What You Can Do Certain medications could help bring your symptoms under control; some can help promote wakefulness during the day, and others can help you sleep at night, says Varga. Even if you’re taking these medications, though, you may still experience a chronic undercurrent of drowsiness.
That’s where lifestyle interventions, such as strategic napping, can be helpful. You may feel refreshed after taking one or more 20-minute naps during the day. But napping isn’t for everyone, notes Varga, as it can leave some people with a fuzzy-headed feeling upon waking. Moreover, you will likely need to speak to your school or employer to arrange accommodations to nap during the day. “On occasion, I’ve had to write a letter explaining that I have prescribed naps, and [the patient is] not just trying to get out of work,” says Varga.
Exercising for at least 20 minutes most days at least four or five hours before bedtime improves sleep quality, and regular exercise has been shown to reduce excessive daytime sleepiness in people with narcolepsy, according to the National Institute of Neurological Disorders and Stroke (NINDS).
You’ll also have to decide whether you’re able to drive a car — a decision that can vary from person to person. “Some patients decide at the outset that they won’t drive because they don’t trust themselves, while others have driven their entire life without an accident,” says Michael Thorpy, MD, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City.
Driving can be extremely risky for someone with narcolepsy who feels tired all the time. But if your symptoms are under control and you get the green light from your doctor, you should be able to get behind the wheel. “Once patients understand their diagnosis, most can adapt and drive safely,” says Dr. Thorpy. “They may drive but put limits on distance or the amount of driving they do alone.” Bottom line: You may be able to drive safely — if you work with your doctor to get the right treatment and set appropriate limits for yourself.
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