Exploring Narcolepsy and Its Link to Alcohol

Narcolepsy is a neurological condition that’s experienced by millions worldwide. This chronic disorder alters sleep-wake cycles, significantly impacting quality of life in those affected and causing daytime sleepiness.

How exactly does it relate to alcohol? Is there such a thing as alcohol-induced narcolepsy? And what about mixing narcolepsy medications and alcohol? 

In this blog, we’ll answer these questions and more! Read on for your comprehensive roadmap of how to navigate the complex relationship between narcolepsy and alcohol.

What Is Narcolepsy?

Narcolepsy is a chronic neurological disorder that impacts the brain's ability to regulate sleep-wake cycles. This condition typically manifests during adolescence or young adulthood, and it currently affects about 200,000 Americans and 3 million people worldwide. 

Those living with narcolepsy experience overwhelming daytime drowsiness and sudden attacks of sleep, regardless of their circumstances. 

Here are five key symptoms of narcolepsy:

• Excessive daytime sleepiness (EDS). This manifests as a profound drowsiness throughout the day, leading to an uncontrollable need to sleep. As a result, the affected person may nap at inappropriate times, such as during work.
• Cataplexy. Cataplexy involves a sudden loss of muscle tone triggered by strong emotions, leading to weaknesses and loss of voluntary muscle control. The affected person may exhibit slurred speech or total body collapse.
• Sleep paralysis. This state refers to a temporary inability to move or speak while falling asleep or upon waking. 
• Hallucinations. These are vivid, often frightening, visual or auditory experiences occurring at the onset of sleep or upon awakening. They can occur alongside sleep paralysis. 
• Disrupted nighttime sleep. Finally, those with narcolepsy experience fragmented, poor-quality sleep at night. This leads to daytime drowsiness and cataplexy, reinforcing a vicious cycle.

Narcolepsy: What Are the Causes?

The cause of narcolepsy is not fully understood, but it's believed to involve a loss of orexin-producing cells in the brain (we’ll discuss these in the next section), which are vital for regulating wakefulness. 

However, there are a few conditions with which narcolepsy is more likely to happen in the absence of low orexin levels:

• Genetic factors (such as having particular genes linked to the condition)
• Autoimmune diseases 
• Traumatic brain injury 

People may be more likely to have narcolepsy if they fall into one of the following:

• Have a first-degree relative who experienced the condition
• Are between 7 and 25 years of age
• Have experienced stroke, head injury, certain infections, or sarcoidosis 

If you or a loved one experiences symptoms and suspects you might have narcolepsy, it’s important to consult with a medical provider for a thorough evaluation and diagnosis.

Narcolepsy and Alcohol: How Does Drinking Affect Symptoms?

Certain people living with narcolepsy do experience symptom exacerbation when drinking alcohol, likely due to alcohol’s sedative effects.

Narcolepsy and alcohol both can lead to daytime drowsiness. If a person already deals with daytime sleepiness from narcolepsy, alcohol can further depress the central nervous system (CNS), making them even more tired. 

To further understand the link between narcolepsy and alcohol, we can look to the orexin (hypocretin) pathway. This neurological pathway in the brain plays a role in both. 

A 2020 study conducted in Neuroscience Letters explains how. This rodent-based study examined the mechanisms for how chronic alcohol use can cause daytime sleepiness. Researchers concluded that alcohol withdrawal decreased orexin expression. 

Orexin, also known as hypocretin, is a brain chemical that regulates our REM (rapid eye movement) sleep. Deficiencies in this hormone can trigger excessive daytime sleepiness. Low levels of orexin is also one of the key causes of cataplexy in those living with narcolepsy. 

Alcohol-Induced Narcolepsy

This begs the question: can alcohol cause narcolepsy? At present, there’s no empirical evidence to suggest alcohol as a causative factor for narcolepsy. 

However, there have been a couple of individual reports of developing narcolepsy after long-term heavy drinking. 

In these cases, recorded in 2012 and 2021, researchers correlated chronic heavy drinking to the onset of narcolepsy. Given that this was correlational, the scientists couldn’t pinpoint whether the individuals in question had undiagnosed narcolepsy prior to being examined, or if the narcolepsy had resulted from the drinking itself. 

As of now, alcohol can not be deemed a likely causative factor for narcolepsy.

Narcolepsy and Alcohol: What About Medications?

Alcohol can affect the efficacy of narcolepsy medications within the body. 

In general, it’s best to avoid mixing alcohol and medication, since drinking can worsen side effects or lead to life-threatening consequences, such as central nervous system depression. 

Alcohol interacts with common drugs used to treat narcolepsy:

• Antidepressants, such as escitalopram oxalate (Lexapro) and fluoxetine (Prozac)
• Stimulants, such as methylphenidate (Ritalin) and modafinil (Provigil)
• Sodium oxybate (Xyrem)

Additional medications used to treat narcolepsy include solriamfetol (Sunosi) and pitolisant (Wakix). Prior to drinking alcohol while taking prescription medication — whether it’s for narcolepsy or another condition — always consult with your physician or pharmacist. 

Narcolepsy Treatment Methods

If your medical team suspects narcolepsy, they’ll conduct a sleep study and measure orexin levels to confirm a diagnosis. 

Aside from medications, narcolepsy involves several lifestyle changes: 

• Improvements in sleep hygiene. This involves minimizing screen time an hour or two before bed, ensuring the sleeping environment is free from noise, and avoiding large meals close to bedtime, among other changes. 
• Dietary adjustments. To ensure optimal sleep, stimulating foods such as caffeine and sugar should be avoided before bed. If acid reflux is an issue, spicy, fatty foods should also be avoided to prevent symptoms from disrupting sleep.
• Strategic daytime napping. To address daytime sleepiness, naps may be needed. If work is an issue, it’s essential to speak to an employer and request accommodations so that naps can be taken. 
• Consistent exercise. Regular physical activity has been proven to regulate and promote healthier sleep-wake cycles. Aim for 30 minutes of moderate exercise daily. 
• Relaxation techniques. Before bedtime, calming activities such as deep breathing, meditation, or aromatherapy can soothe the mind and promote sounder sleep.

Other mind-body methods can be effective in improving narcolepsy symptoms. These include biofeedback, meditation-relaxation therapy, and yoga. 

Will Drinking Less or Quitting Alcohol Improve Narcolepsy Symptoms?

If you’ve found yourself wondering, “Why do I fall asleep when I drink alcohol?” it’s wise to reevaluate your alcohol intake — especially if you have narcolepsy. Falling asleep after drinking alcohol can worsen symptoms and result in dangerous immediate consequences.

Significantly cutting back on or quitting alcohol can potentially improve the condition. Here are a few ways to start changing your drinking habits.

• Evaluate your alcohol Intake. Start by assessing your current alcohol consumption. Keep a diary to track how alcohol intake correlates with the severity of narcolepsy symptoms. If you need help, Reframe’s drink tracker can give you personalized insights into your drinking habits. You’ll also be able to see how much money you’ve saved and how many sleep cycles you’ve gained by reevaluating your drinking habits. 
• Consult healthcare providers. Discuss the potential benefits of reducing or quitting alcohol with your doctor or a sleep specialist. This step is crucial, especially if you're on medications for narcolepsy, as alcohol can interact negatively with these drugs.
• Implement a gradual reduction strategy. If you decide to reduce your alcohol intake, do so gradually. Sudden cessation can lead to withdrawal symptoms, which might temporarily worsen sleep quality.
• Monitor symptoms and adjustments. Pay close attention to any changes in your narcolepsy symptoms as you reduce your alcohol consumption. This monitoring will help you and your healthcare provider understand alcohol’s impact on your condition.
• Explore alternatives for relaxation. Since many people use alcohol as a means to relax, find alternative relaxation methods such as deep breathing, meditation, or light exercise to replace alcohol in your routine.
• Join support groups. Consider joining support groups for people looking to cut back on or quit drinking, especially those with chronic conditions like narcolepsy. Sharing experiences and strategies can be incredibly beneficial. If you’d like to explore options, check out the forum inside the Reframe app. 
• Follow up with healthcare providers. Regular check-ins with your healthcare provider are important to monitor your progress and to make any necessary adjustments to your treatment plan.

By understanding the relationship between alcohol and narcolepsy and taking proactive steps to manage alcohol consumption, those of us living with narcolepsy can potentially improve our symptoms. Remember, this approach should always be personalized and done in consultation with healthcare professionals.

Narcolepsy and Alcohol: Final Thoughts

Narcolepsy is a complex condition that can significantly impact a person’s quality of life. Adding alcohol to the mix can worsen the challenges. It’s essential for those living with narcolepsy to reevaluate their drinking habits so as to avoid symptom exacerbation. Furthermore, medications used to treat narcolepsy can also have adverse — or potentially life-threatening — side effects when mixed with alcohol.

As with any major health condition, it’s essential to consult a healthcare provider for a proper diagnosis and treatment plan if narcolepsy is suspected. With the right steps and plenty of support, it’s possible to live a full life with narcolepsy.