How to Treat Narcolepsy: Are Natural Remedies Beneficial?

Regular Exercise. Exercise can increase energy levels and help reduce stress, which is a factor that can contribute to sleepiness. Moderate-intensity exercise, especially in the afternoon, can help improve sleep quality at night. Aim for 30 to 45 minutes of moderate exercise, such as brisk walking, running, or swimming, or 15 minutes of high-intensity sports like soccer, basketball, or strength training. Consult your doctor or a fitness trainer to create a workout plan that manages narcolepsy.

• If you experience temporary paralysis — a condition where intense emotions or loud laughter cause you to collapse while still conscious — or worry that you may fall asleep during exercise, consider hiring a personal trainer or asking a friend to assist during your workouts.
• Avoid exercising 3 to 4 hours before bedtime, as exercising too close to sleep may affect your ability to get a restful night's sleep.

Take a Morning Walk. Sunlight signals to your body that it’s time to wake up and helps clear your mind. Taking a morning walk outside will make you more alert and give you a daily dose of vitamin D to boost your energy. Those with fair skin may need 45 minutes of sunlight exposure each week to get enough vitamin D, while people with darker skin may require up to 3 hours a week.

• If you’re at home, spend time outdoors daily by walking your dog, gardening, or exercising. If you're working outside, try sitting on the front porch or grass to get enough vitamin D. If you're working in an office, ask to sit near a window and open the blinds to let in natural light.
• Walking at a moderate to light pace for 20-30 minutes can also lower the risk of heart and respiratory diseases, as well as help manage excess body weight, which can contribute to fatigue.

Stay Active Throughout the Day. Light exercises during the day can energize you and help stave off sleepiness. Taking a five-minute break after every 20 minutes of walking can help fight fatigue. Other simple exercises like jumping or stretching are also effective.

• Try standing while reading at school or work. This can help fight sleepiness by keeping your mind occupied.

Avoid Driving When Feeling Drowsy or Stressed. One of the most dangerous aspects of narcolepsy is the sudden onset of sleepiness while driving. You may find that you're more likely to experience drowsiness when you're stressed, rushing, upset, or angry. If that’s the case, avoid driving when you feel any of these emotions. If you feel sleepiness creeping in while driving, pull over safely and rest for a while.

• Avoid stressors such as traffic, construction, not finding a parking spot, frustration with other drivers, or road rage. Stress can trigger sleepiness and pose a danger when you're behind the wheel.

Limit Stress. Excessive stress can lead to anxiety, sleep deprivation, and daytime sleepiness. As people age, it becomes harder to unwind after stressful events. To avoid stress, try practices such as meditation, yoga, or tai chi, spend time on leisure activities, and ensure you get enough rest.

• Simpler stress-reduction techniques include slow, deep breathing in a quiet place, focusing on positive outcomes, prioritizing tasks, eliminating unnecessary responsibilities, and listening to relaxing music.
• You can also use humor to relieve stress throughout the day. Research has shown that laughing is an effective way to cope with high levels of stress.

Let Others Know You Have Narcolepsy. Talking about your narcolepsy with teachers, professors, or employers can be a difficult decision. However, if they don’t understand narcolepsy, they may mistakenly think you're simply inattentive or unmotivated. Since most people are unfamiliar with narcolepsy, it's helpful to prepare a brief explanation about the condition and the symptoms you might experience at school or work.

• Consider asking a sleep specialist to write a brief confirmation of your narcolepsy. This might be a helpful way to validate the condition and clarify your symptoms further.

Practice Tai Chi. Tai Chi is a martial arts-based exercise that involves slow, graceful movements, meditation, and deep breathing. Those who practice Tai Chi regularly tend to be more energetic, have better posture, increased flexibility, and enjoy improved sleep quality at night. Tai Chi can also enhance physical health and mental well-being. You can practice Tai Chi for 15-20 minutes, twice a day at home; it’s a safe exercise for individuals of all ages and fitness levels.

• Typically, Tai Chi is taught in weekly sessions lasting about an hour. The core of Tai Chi involves slow, gentle movements that engage major muscle groups and joints. Meditation is also an integral part of Tai Chi, helping to calm the mind, improve focus, reduce anxiety, and lower blood pressure and heart rate. It also incorporates deep breathing to expel toxins and impurities from the lungs, while inhaling fresh air to improve lung capacity, stretch respiratory muscles, and alleviate stress.
• Tai Chi improves balance, agility, strength, flexibility, endurance, muscle tone, and coordination. It also boosts circulation to the brain, which helps with mental clarity. At the same time, Tai Chi provides fresh oxygen and nutrients to the entire body.

Quit Smoking. Tobacco products like cigarettes and cigars contain nicotine, which can stimulate the nervous system, disrupt sleep, cause sleep apnea, daytime sleepiness, and sudden sleep attacks. Studies have also shown that smokers often have difficulty falling asleep and struggle to achieve restful sleep at night.

• Consult a doctor about smoking cessation methods such as patches, medications, support groups, vaccines, and prescription drugs.

Aim for a Full Night’s Sleep. Getting enough sleep each night helps prevent daytime sleepiness and sudden sleep attacks. If you wake up during the night, try to fall back asleep instead of getting up. Adjust your environment to make sleeping easier if needed. The ideal amount of sleep depends on age, lifestyle, and other factors. Generally, children of school age need 9-11 hours of sleep, while adults over 18 require 7-8 hours.

• Avoid alcohol and sugary foods 4-6 hours before bedtime as they can be stimulating and keep you awake.

Create a Sleep Schedule. Set a consistent time for waking up and going to bed each night. Try to stick to this schedule as closely as possible to help your body adjust to a regular sleep routine. You don’t have to go to bed early, but consistency is key. This will train your body and brain to follow a sleep schedule, making it less likely that you’ll fall asleep at inappropriate times.

• For example, you might set your wake-up time at 7 a.m. and bedtime at 11:30 p.m. Alternatively, you could go to bed at 1 a.m. and wake up at 9 a.m. Follow this schedule every day for a week to help your body get accustomed to waking up and feeling sleepy at certain times.

Dim the lights, creating a dark and soothing environment. Try to create a setting that helps you fall asleep. Minimize light and noise entering the room. Close curtains or blinds to make the bedroom darker. You can also wear an eye mask to block out light. Keep the room cool, usually between 18 - 24°C, and ensure good ventilation to avoid stuffiness.

• When you are in a dark environment, your brain starts producing melatonin, a hormone that regulates sleep.

Avoid electronic devices before bedtime. The light emitted from screens on electronic devices can reduce the amount of melatonin your brain produces. Melatonin is a chemical that helps with sleep. Therefore, a lack of melatonin can make it harder for you to fall asleep. Avoid devices like mobile phones, smartphones, TVs, and computers for at least two hours before going to bed.

Don’t use your bed for other activities. If you often sit on your bed and do various activities, you should change that habit. When you use the bed for things other than sleeping or intimacy, your brain may start associating the bed with wakefulness rather than sleep. This can make it more difficult to fall asleep and wake up on time.

• Avoid working, eating, or watching TV in bed if possible.

Try relaxing once you're in bed. If you're struggling to fall asleep, relaxation techniques may help reduce both physical and mental tension. Stressful activities can lead to the release of cortisol, a hormone that keeps you alert. If you know what helps you relax, incorporate those into your pre-sleep routine.

• To relax before sleep, you can try reading, listening to calming music, or practicing breathing exercises. If you've been lying in bed for more than 20 minutes without falling asleep, get up and go to a low-light area in the house. Do something relaxing until you start feeling tired, then return to bed and try again.

Sleep on your side. If health issues make it difficult to breathe at night, you might need to change your sleeping position. Especially if you suffer from acid reflux, sleep apnea, or even just a mild cold, sleeping on your side may help you breathe more easily and therefore improve your sleep. Try propping your head up on a pillow to support the natural curve of your neck and back for better airflow if you still have trouble breathing.

• Avoid sleeping on your stomach, as this position can block your airway, increase acid reflux, and put unnecessary pressure on your body.

Stop hitting the snooze button. In the morning, when your alarm rings, try your best to get out of bed without pressing the snooze button. Just a few minutes of delay can disrupt your sleep cycle and make you feel even sleepier than if you had gotten up immediately when the alarm went off.

Schedule nap times. Taking two or three short naps during the day can help combat daytime sleepiness. Be sure to schedule these naps during the times when you feel most tired, or around 30 minutes after meals. A nap can refresh you and increase alertness. Each nap should last around 15 to 20 minutes.

• Avoid napping for more than an hour or in the evening as this can disrupt your nighttime sleep and make it harder to fall asleep later.

Manage sleepiness at work. With this condition, you might find yourself feeling drowsy at work, especially if you have a sedentary office job. Think about strategies that could help you work better, like scheduling naps during work or setting flexible start and end times for your workday. Consider discussing this with your employer to improve your productivity while managing the condition.

• Maintaining a cool and well-lit office can also help you stay alert. Try focusing on the less engaging tasks when you're most awake.

Eat a healthy breakfast. Skipping breakfast can leave you feeling tired throughout the day. That’s why breakfast is considered the most important meal of the day. A proper breakfast should include good protein like yogurt or eggs, fresh fruits or vegetables, and low-sugar, high-fiber carbohydrates such as whole grain cereals or oats. Add a handful of almonds or walnuts to provide energy and stabilize blood sugar with their healthy omega-3 fatty acids.

• Try making a smoothie for breakfast by blending fruits, yogurt, wheat germ, and other ingredients with ice for a quick and energizing meal.

Instead of having three large meals, you can stay alert and energized throughout the day by eating smaller meals more frequently. The brain needs regular nutrients to maintain energy levels. Large meals can increase the production of tryptophan, an amino acid that causes drowsiness. Studies show that eating smaller meals, especially in the afternoon, helps regulate blood sugar levels and prevents feelings of fatigue after eating.

• Try eating four or five smaller meals daily, including plenty of fruits, vegetables, and nuts to boost metabolism and reduce daytime sleepiness.

A high-protein diet can elevate your energy levels because many bodily processes require protein. Eating a protein-rich breakfast or lunch helps maintain energy throughout the day. Avoid processed meats, red meat, and margarine, as these foods may increase cholesterol levels, slow metabolism, and cause drowsiness.

• Consume healthy protein-rich foods such as eggs, quail, chicken, turkey, tuna, salmon, sardines, tofu, beans, natural cheese, and Greek yogurt.

Consuming too many carbohydrates causes the brain to absorb more tryptophan, potentially leading to drowsiness. However, this doesn’t mean you should completely eliminate carbs from your diet. Avoid large portions of carbs in the morning or midday; instead, opt for lighter snacks before bed like crackers, cereals with milk, or a slice of toast with peanut butter.

• Consider removing foods like white bread, white pasta, refined sugar, hard candy, gummies, sugary cereals, dried fruits, jams, potato chips, cookies, and rice cakes from your diet.

Foods and drinks with high sugar content can provide a quick burst of energy but often leave you feeling sluggish throughout the day. Studies show that candies and energy bars, in particular, should be avoided because they don’t provide sustained energy and could contribute to weight gain.

• Check the sugar content on food and drink labels before purchasing. Ensure that the sugar content doesn’t exceed 50 grams per serving.
• Another option is to choose fresh, non-concentrated fruit juices and smoothies to avoid sugar.

Water is essential for nutrient transportation to cells and waste removal from the body. Not drinking enough water can slow down your metabolism and cause fatigue. Aim to drink at least eight 240 ml glasses of water every two hours. Electrolyte drinks without caffeine or sugar can also help you stay hydrated.

• To maintain energy during exercise, drink a 240 ml glass of water before starting and another after. If exercising for more than 30 minutes, take small sips every 15-30 minutes.
• On average, an adult should drink about 2 liters of water daily. If consuming caffeinated drinks, increase your intake by 1 liter for each caffeinated beverage.

Limiting your caffeine intake is crucial. Beverages containing caffeine, like coffee and tea, can help you stay alert, especially when battling narcolepsy. However, when combined with certain stimulants, caffeine may cause restlessness, diarrhea, anxiety, or a racing heart. It’s generally advised to limit caffeine consumption to two cups of tea or one cup of coffee, preferably consumed before late afternoon.

• If coffee is part of your daily routine, try to avoid drinking it after 4 p.m. Consuming caffeine late in the day can interfere with your ability to get a good night's sleep.

Many believe that drinking alcoholic beverages before bedtime aids sleep. While alcohol may initially relax you, it can disrupt your sleep cycle during the night, preventing you from getting a full night’s rest and causing daytime drowsiness. You should try to reduce or eliminate alcohol to avoid sudden sleep attacks and narcolepsy.

• The recommended alcohol intake is two drinks per day for men and one for women.
• Consider consulting your doctor about the right amount of alcohol for your condition.

Brew chamomile tea. Chamomile is an herb commonly used to alleviate anxiety, nausea, and insomnia. A warm cup before bed can help you feel relaxed, sleep soundly, and reduce daytime sleepiness. To prepare chamomile tea, steep one teaspoon (2-3 grams) of dried chamomile flowers in boiling water for 10 minutes, then strain and drink before sleep.

• Consult your doctor before using chamomile tea if you are taking other medications or herbs for insomnia, have low blood pressure, or are pregnant.
• Avoid chamomile if you are allergic to daisies or related flowers.

Use lemon balm. Lemon balm is a herb often used to reduce anxiety and aid sleep. It’s typically combined with other calming herbs like valerian and chamomile to promote relaxation. Lemon balm is available as a supplement, with a recommended dose of 300 mg to 500 mg, three times a day or as needed.

• If you wish to make lemon balm tea, steep one teaspoon of dried lemon balm leaves in a cup of hot water for about five minutes, strain, and drink before bedtime.
• Pregnant or breastfeeding women, as well as those with hyperthyroidism, should consult a doctor before using lemon balm.

Drink valerian root tea. Valerian root is a popular herb that serves as an alternative to prescription medications for treating anxiety and insomnia. It is considered safe and gentle for alleviating these conditions. This herb can also help you fall asleep faster and improve the quality of your sleep. For a better night's sleep, you can brew valerian root tea by steeping one teaspoon of dried valerian root in a cup of hot water for about 10 minutes. Drink a cup before bed.

• Valerian root is also available in powder and liquid extract forms.
• Do not use valerian root without consulting a doctor if you are taking prescription medications or other herbs for sleep issues or depression. You should also consult a doctor before giving valerian root to children.

Try Saint John's wort. Narcolepsy can often lead to anxiety and depression. Saint John's wort is an herb commonly used to treat mild to moderate depression. This herb is available in liquid extract, capsules, tablets, and commercial teas. Consult your doctor to determine which form is right for you. Supplements usually contain 0.3% hypericin, one of the active compounds in this herb. You can take the supplement at 300 mg, three times a day. It may take 3 to 4 weeks to see significant improvement.

• Do not stop taking Saint John's wort abruptly, as this can cause unpleasant side effects. Gradually reduce the dosage before discontinuing.
• Saint John's wort should not be used to treat severe depression. If you experience thoughts of harm or suicide, contact emergency services immediately (911 in the US, 1800 1567 in Vietnam) or see a doctor right away.
• If you feel drowsy or have increased sleepiness, stop using the herb.
• Patients with attention deficit disorder or bipolar disorder should avoid using Saint John's wort.
• Do not use Saint John's wort if you are on medications such as antidepressants, sedatives, birth control, or allergy medications. Pregnant or breastfeeding women should also avoid it.

Try rosemary. Rosemary is a commonly used herb that can help reduce episodes of narcolepsy by improving memory and concentration. You may try using rosemary as a food supplement for 3 to 4 months to alleviate narcolepsy symptoms. Rosemary can enhance circulation and boost digestion, both of which can help increase brain alertness.

• The total amount of rosemary you consume, whether in supplement form or as a spice in meals, should not exceed 4 to 6 grams per day.
• Rosemary can cause dehydration and low blood pressure (hypotension). In rare cases, high doses of rosemary may lead to seizures. Only use rosemary as recommended by a healthcare professional.

Determine if you are at risk of the condition. Narcolepsy may be caused by low levels of hypocretin, a chemical in the brain that helps maintain alertness. Experts believe that certain factors can combine to cause hypocretin deficiency, such as genetic predisposition, brain injury, autoimmune disorders, low histamine levels, and environmental toxins. Genetics alone do not cause narcolepsy.

• Other sleep disorders related to narcolepsy, such as chronic fatigue syndrome, excessive sleep, insomnia, sleep paralysis, and sleep apnea, can increase the risk of developing narcolepsy.
• If you suspect you have narcolepsy, you should consult a doctor for appropriate diagnostic methods and treatment plans as soon as possible.

Recognize the symptoms. Narcolepsy is quite rare, and it can take 10 to 15 years after the first symptoms appear before an accurate diagnosis is made. People with narcolepsy may experience sudden bouts of sleep, loss of muscle control, hallucinations, and sleep paralysis. The most prominent symptom of narcolepsy is overwhelming daytime sleepiness, which is accompanied by mental fatigue, memory issues, low energy, and depression. These episodes can occur during any activity, such as talking, eating, reading, watching TV, or sitting in a meeting. Each episode may last for 30 minutes or less.

• Excessive daytime sleepiness is often a sign of narcolepsy and is frequently accompanied by intense emotions such as anger, fear, or excitement, which can trigger sleep attacks.
• Temporary paralysis is another symptom of narcolepsy, often triggered by emotions or other stressors. During temporary paralysis, muscle tone is lost while the person remains awake, making it difficult to move the head or speak. Some people may lose control over their muscles entirely, causing them to drop items or fall. These episodes usually last a few seconds to a few minutes and can occur weeks or years after the first sleep episode. The person remains conscious during the paralysis.
• Hallucinations can occur during sleep onset, when waking up, or during the transitional phase between sleep and wakefulness. These hallucinations can seem incredibly vivid, making you feel like you can see, hear, smell, and taste everything around you.
• Children with narcolepsy may experience severe daytime sleepiness, difficulties in learning and memory, and may fall asleep while talking, eating, or during social events and sports activities. They may also display hyperactivity.
• These symptoms can range from mild to severe. Most people with narcolepsy struggle with falling asleep and maintaining sleep, which exacerbates daytime sleepiness.

Keep a sleep diary. If you suspect you may have narcolepsy, it's a good idea to start keeping a sleep diary before visiting your doctor. Your doctor will likely need to know when you first noticed any symptoms and whether they have disrupted your sleep or daily schedule. They may also want to learn about your sleep habits and your daytime feelings and activities. Keep the diary for several weeks before your appointment to track how long it takes you to fall asleep, how much sleep you get each night, and your alertness levels during the day.

• You should also note any factors that may increase your risk of narcolepsy, such as family history, brain injuries, exposure to toxins, or any autoimmune or sleep disorders you may have.

Visit a doctor. Your doctor will assess whether another condition may be causing your symptoms. Infections, thyroid disorders, stimulant or alcohol use, and other health conditions or sleep disorders may produce symptoms similar to narcolepsy. Make sure to inform your doctor about any medications, herbs, or supplements you are taking, as some can lead to daytime sleepiness.

• Your doctor may recommend a hypocretin test to measure the levels of hypocretin in the cerebrospinal fluid. To collect this sample, the doctor will perform a lumbar puncture, which involves inserting a needle into your lower back to extract the cerebrospinal fluid.

Undergo a polysomnography (PSG) test. If narcolepsy is suspected, your doctor may suggest seeing a sleep specialist. The sleep specialist may recommend a sleep study called polysomnography (PSG). This process records brain activity, eye movements, heart rate, and blood pressure while you sleep.

• Typically, you will need to stay overnight at a sleep center for the PSG test. The PSG will help your doctor determine whether you fall into sleep quickly, enter rapid eye movement (REM) sleep right after falling asleep, and whether you wake up frequently during the night.

Take a Multiple Sleep Latency Test (MSLT). The Multiple Sleep Latency Test (MSLT) is a study that evaluates your daytime sleepiness levels. This test is usually conducted the day after the PSG. During the test, you will be asked to nap every two hours for 20 minutes throughout the day. You will have a total of 4 or 5 short naps, during which the technician will monitor your brain activity, measure how quickly you fall asleep, and track the stages of sleep you enter.

• The MSLT helps assess how quickly you fall asleep during the day after a full night’s rest. It also measures whether you enter REM sleep soon after falling asleep.

Ask your doctor about sleep apnea. If you frequently experience breathing interruptions during sleep, consult your doctor about treatment options. Interrupted breathing can make it more difficult to fall asleep, leading to excessive daytime sleepiness, headaches, and concentration problems. Your doctor may recommend treatment with surgery or the use of a continuous positive airway pressure (CPAP) machine.

• There are three types of sleep apnea: obstructive, central, and mixed.
• CPAP is a widely used treatment for sleep apnea, which involves a small machine that provides continuous and steady air pressure, a tubing, and a mask. Some CPAP devices also come with a humidifier to assist patients with chronic respiratory conditions like bronchitis or sinusitis.

Talk to your doctor about medication. While there is no cure for narcolepsy, several medications can help manage the condition. Your doctor may prescribe stimulants such as modafinil, which is non-addictive compared to other stimulants and does not affect mood. The side effects of modafinil are rare but may include headaches, nausea, and dry mouth. Some patients may need treatment with amphetamine-based stimulants, which are also effective but may cause side effects like palpitations, jitteriness, and potential for addiction.

• Serotonin inhibitors are also prescribed to limit rapid eye movement (REM) sleep during the day to help reduce symptoms of temporary paralysis, sleep paralysis, and hallucinations. Side effects may include sexual dysfunction and digestive issues.
• Tricyclic antidepressants are effective for those suffering from temporary paralysis but often come with side effects such as dry mouth and dizziness. Sodium oxybate is highly effective for patients with temporary paralysis by improving nighttime sleep and controlling daytime sleepiness. However, it may cause side effects like bed-wetting, nausea, and worsen sleepwalking. When combined with other sedatives, certain herbs, supplements, alcohol, or painkillers, this medication can cause breathing difficulties, coma, and even death.
• Over-the-counter medications like cold and allergy pills can induce drowsiness. If you have narcolepsy, your doctor may advise avoiding these medications.