Narcolepsy

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People with the neurological sleep disorder narcolepsy may be at a greater risk of engaging in impulsive, reward-seeking behaviors, such as alcohol misuse (1), due to shared chemical processes in the brain. Also, self-medication among people experiencing mental and physical health issues, including sleep disorders, is common. (2) Regularly misusing alcohol, however, will not improve narcolepsy symptoms and can even worsen them. It can also lead to the development of other health conditions associated with drinking, including dependence and addiction.

If you have narcolepsy and cannot control your drinking, you might have an alcohol use disorder and would benefit from professional treatment. At Guardian Recovery, we offer integrated treatment programs designed to address addiction’s underlying causes, including the physical and mental health issues that contribute to its development.

Contact us and learn more about how we help individuals struggling with substance misuse overcome active addiction and reclaim the healthy and fulfilling lives they deserve.

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An Overview of Narcolepsy

Narcolepsy is a chronic neurological condition impairing the brain’s ability to regulate sleep and wakefulness. This disorder is hallmarked by excessive daytime drowsiness, nighttime sleep disturbances, and other issues involving an individual’s sleep-wake cycle. Symptoms associated with narcolepsy also include: (3)

  • Lack of energy and exhaustion while awake.
  • Memory lapses and concentration difficulty.
  • Cataplexy, or abrupt muscle tone loss while awake, leading to weakness and reduced voluntary muscle control.
  • Vivid, frightening hallucinations while falling asleep or waking up.
  • Sleep paralysis, or an inability to speak or move while falling asleep or waking up.
  • Automatic behaviors, which occur when a person falls asleep during an activity and automatically continues the action for a short time without conscious awareness of it.
  • Disrupted sleep due to vivid dreams, breathing issues, and bodily movements.

An estimated 1 in every 2,000 Americans is affected by narcolepsy, representing about 200,000 individuals. Symptoms usually onset between ages 10-30 but can occur at any age. (4)

Type I vs. Type II Narcolepsy

An individual is most often diagnosed with type I narcolepsy (with cataplexy) due to having low levels of the naturally-occurring hormone hypocretin, which regulates REM sleep and promotes wakefulness. This type may also be assigned to a person who exhibits both cataplexy and excessive daytime sleepiness on a sleep test. (5)

Type II narcolepsy (narcolepsy without cataplexy) is diagnosed when a person experiences excessive daytime sleepiness but not usually cataplexy. As a result, their symptoms tend to be less severe, and they have normal hypocretin levels. (6)

The Relationship Between Drinking & Narcolepsy

Current research suggests many cases of narcolepsy result from a combination of factors collaborating to reduced hypocretin in the brain, such as autoimmune disorders. (7) The hypocretin system controls motivation for addictive substances, such as alcohol, and has “potential interactions with impulsivity, decision making, and reward-based learning.” (8)

Several studies have examined various links between symptoms associated with both narcolepsy and impulsivity. Evidence suggests those affected by the former may be at an increased risk of engaging in risk-taking behavior, including substance misuse.

For example, a 2011 study found that subjects diagnosed with type I narcolepsy (with cataplexy were substantially more impulsive than those without it. (9) Further research revealed a significant number of study subjects reporting having substance use disorders, particularly related to alcohol, narcotics, and multiple substances (polysubstance.) Approximately half also reported using drugs to induce sleep or to help with sleep-related issues. (10)

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Can Narcolepsy Lead to Drinking & Substance Misuse?

Sleep disorders are both mentally and physically exhausting. As a result, it’s not uncommon for those affected by these conditions to use over-the-counter sleep aids, prescription medication, alcohol, or even illicit drugs to help induce and sustain sleep.

Although alcohol is a depressant that reduces activity in the body, it can also adversely affect sleep cycles and impair a person’s ability to experience the deep REM sleep needed to physically and mentally recover and feel rested. To explain, “chronic alcohol use is associated with longer sleep latency, altered NREM sleep, decreased and disrupted REM sleep, and reduced total sleep time.”(11)

As a result, a person with narcolepsy might find the day after a drinking episode even more daunting than it would otherwise. Those facing prolonged periods of wakefulness related to work, school, driving, or other activities may turn to stimulants, such as amphetamines, to increase energy and improve alertness.

Prescription & Non-Medical Drug Use

Regular use of any psychoactive substance, such as amphetamines, with the potential for misuse or dependence, can lead to full-blown addiction. That said, those who take these medications as prescribed for narcolepsy under medical supervision may be at relatively low risk for this to occur. (12)

However, individuals who obtain them illicitly or via doctor shopping may be more vulnerable to developing problems related to substance misuse. Habits acquired to self-medicate for exhaustion can rapidly develop into problematic patterns of substance misuse and lead to numerous health complications and adverse consequences.

Once a person has become dependent on alcohol or drugs, their brain and body have come to rely on their effects and cannot function correctly without them. This can add another element to a person’s sleep struggles, as they may come to require the substance to achieve any amount of sleep, albeit it minimal or poor.

Narcolepsy caused by or affected by alcohol is not to be confused with passing out from excessive drinking, as symptoms are nearly identical to a type I or type II narcoleptic condition. (13) However, when heavy alcohol use is also a factor, this could contribute to the worsening of some symptoms and the addition of new ones. For example, blackouts caused by extreme intoxication could cause further complications.

Symptoms of Alcohol-Induced Narcolepsy Include:

  • Excessive daytime sleepiness.
  • Frequent waking and inconsistent, interrupted sleep.
  • Falling asleep while engaging in an activity or exhibiting cataplexy/limp or weak muscles.
  • Experiencing vivid images or hallucinations.
  • Having sleep paralysis before falling asleep or immediately upon waking.

Co-Occurring Treatment for Narcolepsy & Alcohol Addiction

Individuals diagnosed with narcolepsy and alcohol dependence are best served when both disorders are addressed concurrently. Attempting to treat one while overlooking the other will likely be counterproductive and undermine the efficacy of interventions targeting any single condition.

The most effective integrated treatment programs for addressing dual diagnoses typically include the following:

  • Use of healthcare professionals from diverse backgrounds and disciplines, such as psychiatrists, specialized therapies, physicians, counselors, etc.
  • Use of a comprehensive assessment that can identify diagnosable conditions and other mental/medical health issues.
  • Development of a customized, all-encompassing treatment plan that considers the person’s unique circumstances and specific care required for each issue.

The causes and effects of alcohol use disorders are complex and vary widely between individuals. To provide individuals with the best chance for long-term recovery, all factors linked to these conditions should be included in an integrated approach. According to a study in the Social Work Journal of Public Health, “Integrated treatment for comorbidity has been found to be consistently superior compared to treatment of individual disorders with separate treatment plans.” (14)

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Treatment can be more challenging for individuals who struggle with substance use and a co-occurring mental or physical health condition. For this reason, those with a dual diagnosis often require a unique approach to treatment, including therapeutic services designed to address both disorders and their overlapping symptoms simultaneously.

Guardian Recovery provides effective, evidence-based treatment for those seeking to break free from addiction, foster long-term sobriety, and improve the quality of their life. Our holistic programs combine traditional approaches, such as behavioral therapy, counseling, and group therapy, with medicated-assisted treatment and other clinically-proven methods to be beneficial for recovery.

Contact us today to speak with an experienced Treatment Advisor and learn more about our customized treatment plans and various levels of care. We’ll also provide you with a free, no-obligation assessment and health benefits check, answer your questions, and help you get started on your recovery journey.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)(9)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113969/ (2)https://nida.nih.gov/about-nida/noras-blog/2020/03/connections-between-sleep-substance-use-disorders (3)https://rarediseases.org/rare-diseases/narcolepsy/ (4)https://narcolepsynetwork.org/about-narcolepsy/narcolepsy-fast-facts/ (5-7)https://www.ninds.nih.gov/narcolepsy-fact-sheet#3201_4 (8)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738042/ (10)https://pubmed.ncbi.nlm.nih.gov/19855859/ (11)https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.16110307 (12)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510672/ (13)https://www.ijsm.in/abstractArticleContentBrowse/IJSM/24403/JPJ/fullText (14)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753025/

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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