Narcolepsy and Parkinson's Disease

Parkinson’s disease (PD) is a disorder that affects the nervous system. It is a chronic condition that gets worse slowly over time. Parkinson’s disease main symptoms impact the ability to move (motor symptoms) such as tremor at rest, stiffness of the limbs, difficulty walking, and impaired balance. Other motor symptoms can also include small handwriting, stooped posture, softness of voice, and problems swallowing.

PD also affects other brain functions (non-motor symptoms) such as reduced ability to smell, sleep issues, constipation, and low blood pressure when standing up.

People with Parkinson’s disease often have daytime sleepiness, sleep attacks, and other sleep issues. Doctors believe this is because Parkinson’s disease may damage the small area of the brain that controls production of orexin/hypocretin. This damage causes low levels of the brain chemicals that control the body’s sleep-wake cycles.1-2

Two different conditions

While the end result can be the same as in narcolepsy, the conditions are not the same. People with narcolepsy do not have an increased risk of developing Parkinson’s and vice versa.1

Parkinson’s affects about 1 million people in the United States. It is the second most common neurological disease behind Alzheimer’s. Narcolepsy, on the other hand, is rare. Between 135,000 and 200,000 people in the U.S. have been diagnosed with narcolepsy.3-4

Narcolepsy-like symptoms in Parkinson’s

Narcolepsy-like symptoms are common in people with Parkinson’s disease. One study found that 3 out of 4 people with Parkinson’s have excessive daytime sleepiness.1 Another study of 100 veterans with PD found that slightly more than half had daytime sleepiness, often with cataplexy, hallucinations, and sleep paralysis.2

Other studies have found that daytime sleepiness, sleep attacks, and other sleep disorders often begin years before other symptoms of Parkinson’s. It is thought these sleep issues begin gradually as the brain produces less hypocretin.5

Narcolepsy-like sleep issues can vary widely in people with PD. Some people experience very mild symptoms for years while others have sudden, dramatic symptoms. Still others have no narcolepsy symptoms but may have insomnia, restless legs syndrome, or periodic limb movement disorder.1

Treatment for narcolepsy symptoms in Parkinson’s

Narcolepsy drugs are sometimes used to control daytime sleepiness and sleep attacks in people with Parkinson’s. These drugs include stimulants that keep the person awake during the day and sedatives for nighttime sleep and hallucinations.1

A small Swiss study found that sodium oxybate, a drug commonly used to treat narcolepsy, improved daytime sleepiness and sleep disturbances in people with Parkinson’s. However, the study was too small to determine safety.6

Good sleep hygiene is important to help control Parkinson’s related sleep issues, just as with people who do not have Parkinson’s. Tips for sound sleep include:

  1. Keeping a regular sleep schedule
  2. Controlling the timing of daytime naps
  3. Getting exercise and sunlight early in the day to increase alertness
  4. Using light therapy if unable to get outside
  5. Decreasing how much you drink late in the day to reduce nighttime trips to the bathroom (nocturia)

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Written by: Jessica Johns Pool | Last reviewed: June 2020