Narcolepsy Changes Across the Lifespan
Just like any other chronic or long-term condition, narcolepsy can change across the lifespan. Children may require different treatment options than adults. Pregnant women may need to change or stop medications. Older individuals may have other co-occurring conditions or drug dosing needs that have to be considered.1-3
Working with your doctors over time, especially during times of change or severe symptoms, can help create a treatment plan that is best suited for your specific life situation.
Narcolepsy in children
There are many considerations that need to be made when treating a child who has narcolepsy. When it comes to medications, children may need different dosages or medication schedules than adults. Their bodies are smaller and their metabolisms are different, both of which can impact how their body responds to certain drugs. Also, some drugs may have negative side effects for kids. For example, amphetamines, which are commonly used to treat narcolepsy, may impact a young child’s growth.1,2 This effect can vary based on how long a child is taking these medications.
Kids also have other important factors to consider, especially when it comes to learning. School can be quite a challenge for a young child with narcolepsy who is sleepy during class or who has other symptoms during the day. Some research has suggested that kids with narcolepsy may be more likely to have attention deficit hyperactivity disorder (ADHD). A lack of good sleep may also impact memory storage and retrieval.3 These factors can all impact a child’s performance in school.
Sticking to a regular schedule and finding ways to talk with a child about their narcolepsy can help normalize things. It can also encourage them to reach out for help when they need it. Open communication may also help children better talk with their friends and teachers at school about their needs. Additionally, having a signal between the child and their teacher when they need a stretch break or extra support may also be helpful.2,3
Considerations for pregnant women
A big concern for many pregnant women is the impact certain medications can have on a growing baby. Many narcolepsy medications are considered pregnancy Category C.1 This means, studies on animals have shown that they may harm an unborn baby, but no human studies have confirmed this. The benefits of taking the drug must be weighed against the potential costs to determine if it is necessary to continue with treatment.
Under doctor’s supervision, many women may find it easier to stop taking their narcolepsy medications while pregnant, and restarting treatment after giving birth.2 Communicating with a doctor about personal needs and symptoms can be helpful in determining the right approach. This is especially true for women who experience cataplexy (brief loss of muscle tone). Cataplexy can sometimes occur during labor, and doctors can prepare in case this happens.1
Narcolepsy in adults
Many people with narcolepsy will be diagnosed for the first time in adulthood. Because symptoms can overlap with other conditions, or may not be recognized as part of a bigger problem, it can often take years to receive an accurate diagnosis. Being diagnosed with narcolepsy in adulthood can lead to significant changes. Adults with narcolepsy may also have ADHD or mood disorders that need treatment, too.3
Even for people who were diagnosed before adulthood, symptoms can change as they age. Narcolepsy may change in severity, or other sleep-related conditions can develop as well (like sleep apnea).2 When trying different treatment options, daytime drowsiness may occur depending on the drugs used and their side effects. These factors can all impact a person’s daily life. Regularly working with your doctor as your needs and symptoms change can help best guide treatment.
The changing health needs of the elderly
Treating older adults with narcolepsy requires many considerations. As a person gets older, they are more likely to develop other medical conditions. Their body also processes drugs differently. Both of these factors may impact the types and dosages of drugs that can be used.
For example, people with heart conditions may no longer be able to take amphetamines or certain antidepressants for their narcolepsy. People with high blood pressure or heart failure may not be able to take sodium oxybate because it could impact salt balance in the body and impact these health conditions. Other medications may lead to dizziness or an increased risk of falling, which can be especially concerning for older adults. Further, some medications may cause daytime sleepiness.1-3 While some may be able to manage narcolepsy or medication side effects through daytime naps, especially if they are no longer working, others may not be in a position to navigate these issues.
Ultimately, narcolepsy can be a long-term condition and treatment approaches may need to be adjusted as a person goes through different stages of their life. A great way to make sure your treatment plan is best suited for whatever your current life needs are is to keep open lines of communication with your doctor and be open to changes when needed.
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