Long-Term Benefits of Treating Narcolepsy

Untreated narcolepsy places a huge burden on the lives of people living with the condition. Problems at school and work are common, leading to poor education and unemployment. Relationships suffer from misunderstandings and the fatigue, depression, and anxiety people with narcolepsy may have. More than affecting just sleep, people with untreated narcolepsy also have higher rates of high blood pressure, diabetes, sleep apnea, and obesity.

It can take years to be correctly diagnosed with narcolepsy. But once treatment begins, what are the long-term benefits to those treatments?

The case for treatment

One study from the 1990s found many benefits to taking modafinil. Modafinil is one of the most widely prescribed stimulants used to treat narcolepsy. The study followed nearly 500 people with narcolepsy for almost a year. A third took 400 mg of modafinil, a third took 200 mg of modafinil, and a third took a placebo (a pill with no drug).¹

At the end of the study, people who took 400 mg of modafinil reported having:¹

• Much more energy
• Fewer hardships performing daily activities
• Fewer problems with social activities
• Better mental health and self-esteem
• Higher productivity and attention levels

A study from 2020 looked at 226 people with narcolepsy who took the stimulant solriamfetol for about a year. At the end of the year, people taking the drug reported:²

• Fewer issues with social activities
• Much higher productivity at work

In addition to improving workplace performance and thus employment, treating narcolepsy reduces the number of driving and workplace accidents.³

Mental health issues better controlled

Depression and anxiety are common among people with narcolepsy. In fact, some studies say depression and anxiety are at least twice as likely in people with narcolepsy than other people. This is especially true for people with untreated narcolepsy.^4,5

One study from 2020 followed people with untreated narcolepsy for about a year to track if mental health improved with treatment. The study’s results highlighted how important it is to treat narcolepsy in order to improve mental health with the disorder. The study found that people with narcolepsy and moderate to severe depression were:⁶

• Less well educated
• More often obese
• Had more severe narcolepsy symptoms and more automatic behaviors
• Poorer quality of life overall
• Had more suicidal thoughts

It makes sense that if someone can stay awake, think clearly, and pay attention, they will perform better at school or work. It also makes sense that better control of cataplexy and automatic behaviors would make social gatherings more enjoyable and reduce the number of injuries someone gets from episodes of cataplexy. Taken together, treating narcolepsy improves overall well-being, which makes depression and anxiety less likely or less severe.^3,5

Weight and heart health better managed

People with narcolepsy are often overweight or obese, which can contribute to high blood pressure and diabetes. Doctors believe this weight gain has to do with the loss of the hormone hypocretin (also called orexin). Low levels of this hormone cause narcolepsy and slow how the body uses calories (metabolism).

This makes regular exercise especially important to help manage weight, reduce depression, and improve nighttime sleep. A walk of at least 20 minutes a day, at least 4 to 5 hours before bedtime, is recommended.^7,8