Can Stress Trigger Narcolepsy Symptoms?

Narcolepsy is a sleep disorder that makes it hard to stay awake. It causes excessive daytime sleepiness (EDS). EDS can make it hard to work, be social, or have relationships.¹

Type 1 narcolepsy can also cause a loss of muscle tone. This is called cataplexy. Type 1 narcolepsy symptom can be triggered by laughing and strong emotions.¹

Stress may also trigger your narcolepsy symptoms. It may affect a chemical called orexin. And orexin could impact your narcolepsy. More work needs to be done to understand the link between stress and narcolepsy.²

What causes narcolepsy with cataplexy?

A brain chemical called orexin (also called hypocretin) plays a role. Orexin impacts how awake you are. Too much orexin causes a high stress response. Not enough orexin makes you sleepy. People with type 1 narcolepsy have low levels of orexin.^1,3

Low orexin levels can disturb REM (rapid eye movement) sleep. REM is the stage of sleep when you do most of your dreaming. The quality of REM sleep you get can affect your:^2,4

• Long-term memory
• Ability to concentrate
• Mood
• Immune system

Low orexin levels can also cause EDS and cataplexy. Orexin is so important that doctors often use it to diagnose narcolepsy. Orexin has long been linked to sleeping patterns. But it is also linked to stress.^2,3,5

Can stress trigger narcolepsy symptoms?

We experience stress in 1 of 2 ways – acute or repeated.²

Acute stress starts suddenly. Though acute stress can be intense, it is short-lived.²

Repeated stress can have no end. It can be high or low intensity, but it lasts for a while. Sometimes the body adapts to repeated stress. But sometimes it does not.²

Acute and repeated stress

The body responds to acute stress by making orexin. This causes a stress response and allows us to react. Orexin levels rise and fall. This allows the body to react when it needs to and tone down the response when it needs to.²

The link between orexin and repeated stress is not clear. Some studies show that when stress is “chronic, predictable, and inescapable,” it can cause:²

• Low levels of orexin
• Inability to cope
• Depression

This means that chronic or long-term stress, like that which may come with narcolepsy, could lower orexin levels and worsen narcolepsy symptoms. But repeated stress has also been shown to raise orexin levels.²

The fact that scientists have found these opposing results is likely due to the way their studies were done. More work is needed to truly understand the link between stress and narcolepsy.²

How else can stress impact my sleep?

Stress also causes nightmares. People under a lot of stress or who feel emotionally unstable have more nightmares. These nightmares can cause more anxiety or fear. This can raise your stress level even more. Plus, nightmares disrupt sleep, which can worsen EDS.⁶

In some people, stress also causes insomnia. In other people, stress causes EDS. A 2020 study of 441 medical students showed that higher stress levels and EDS were linked. Students who felt high levels of emotional stress had higher levels of EDS.^7,8

How can I lower my stress?

Stress impacts your whole body. If you have a chronic condition like narcolepsy, getting good sleep improves your health and may help control your condition. Other activities that may lower stress include:⁹

• Exercising
• Journaling or meditating
• Counseling
• Listening to or playing music
• Being with family and friends

There are likely many narcolepsy triggers. Stress is possibly one of them. Lowering your stress may improve your narcolepsy symptoms as well as your overall health.^5,10