Non-pharmacological approaches to the treatment of narcolepsy

• Published in: Sleep (New York, N.Y.) Vol. 17; no. 8; pp. S97 - S102
• Main Authors: GARMA, L, MARCHAND, F
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Rochester, MN American Academy of Sleep Medicine 01-12-1994
• Subjects: Adolescent; Adult; Biological and medical sciences; Caffeine; Circadian Rhythm; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Employment; Feeding Behavior; Female; Humans; Hypnosis; Male; Medical sciences; Middle Aged; Narcolepsy - therapy; Nervous system (semeiology, syndromes); Neurology; Relaxation Therapy; Self Concept; Stress, Psychological; Wakefulness; Human; Nervous system diseases; Treatment efficiency; Sleep disorder; Labour; Psychological effect; Feeding; Rest; Diet; Narcolepsy; Behavior therapy; Psychopathology; Neurological disorder; Psychiatry
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/17.suppl_8.S97

A way of evaluating the part played by non-drug treatments is to study cases of patients who discontinued stimulant medications but still came back for follow-up visits. Out of 40 patients with narcolepsy-cataplexy, three refused medication because their work was compatible with a regimen of naps (follow-up 1 year), and 10 stopped taking drugs when they could adapt nap therapy to a new life-style (follow-up 6.9 +/- 5 years). Three interrelated levels of non-pharmacological treatments of narcolepsy were examined: 1) Behavioral management, which includes: (A) structured sleep schedules: literature shows that a single long afternoon nap proffered greatest performance benefits in reaction time, significantly increased over a no-nap control condition, with no evidence of sleep inertia. The placement of this nap might yield better results if scheduled 1 hour before that of a normal subject. (B) Dietary factors: little is known about the effects of diet in narcoleptics; however, avoiding simple sugars will improve alertness in some patients. 2) Medical and psychiatric aspects of care. 3) Social factors as an interface between the patients and their environment.