Comorbid Conditions of Your Narcolepsy

Sometimes your narcolepsy appears with other conditions. We call these comorbid conditions or comorbidities. These are the common comorbid conditions seen with narcolepsy.

Obstructive Sleep Apnea

Sleep apnea is the most common of all narcolepsy comorbidities. Obstructive sleep apnea is a sleep-related breathing problem that happens when there’s a narrowing or obstruction in your airways. Your breathing problems can result from differences in your anatomy. By anatomy, we mean your airways. In most cases, your airways collapse while you sleep. This is what causes your airway obstruction. On the other hand, your sleep apnea can be caused by problems with your airway muscles or function or even unstable breathing control while you sleep. This is what causes your sleep and breathing symptoms.

• Excessive daytime sleepiness.
• Feeling sleepy or tired even after you wake up.
• Waking up coughing and choking.

You can’t get rid of sleep apnea. But you can manage it by making certain lifestyle changes and using different treatments, such as weight loss and breathing treatments.

Fibromyalgia

Another comorbid condition for narcolepsy is fibromyalgia. Healthcare providers classify fibromyalgia as a chronic pain condition because it causes pain all over your body. We don’t know what causes fibromyalgia. But some of you are predisposed because of negative or stressful events or environments.

• Fatigue.
• Insomnia.
• Morning stiffness.
• Mental health conditions like depression or anxiety.

Treating fibromyalgia can be tricky because healthcare providers don’t know what causes it in the first place. But, lifestyle changes, therapy, and certain prescribed medications may help with the effects of your fibromyalgia.

Nocturnal Eating Disorder

Have you ever heard of a nocturnal eating disorder? It’s another comorbid condition of narcolepsy. You may question how an eating disorder happens with a sleep disorder. We’re here to tell you. These eating disorders happen when there’s an imbalance of the hormones that control your sleep-wake cycles and your appetite. You don’t feel hungry during the daytime, but you feel hungry at night. Nocturnal eating disorders don’t cause you to eat in your sleep, but you eat late or wake up in the middle of the night to eat. What’s most interesting about nocturnal eating disorders is that the eating disorder only occurs at night, hence its name!

You know that nocturnal eating disorders present with sleep disorders. It also appears with other physical health and mental health conditions like obesity, depression, and anxiety. Nocturnal eating disorders usually occur after a stressful life event. Your healthcare provider will diagnose you based on one or more of these symptoms.

• Insomnia.
• Morning anorexia.
• Excessive nighttime hunger.
• No daytime eating disorders. 
• An urge to eat late at night or in the middle of the night.

Nocturnal eating disorders are a puzzling condition, and there isn’t one right way to treat your condition. This means that your healthcare provider develops a plan of care that’s specific to your unique situation. It may include prescribed medications, therapy, or alternative therapies.

Sleep-Related Eating Disorders

We believe that sleep-related eating disorders are a spectrum of disorders with co-occurring sleep and eating disorders. This makes them another one of the comorbid conditions for your narcolepsy. Nocturnal eating disorders fall within that spectrum. So there are many similarities between disorders. But, there are also huge differences.

We don’t know what causes sleep-related eating disorders. Some cases happen following stressful events or even certain psych medications. But we don’t know how this happens. Next, you don’t remember your nighttime eating episodes. This means that you may not be fully awake while you’re eating. Sleep-related eating disorders are comorbidities for different sleep disorders, not just narcolepsy. Like nocturnal eating disorders, sleep-related eating disorders occur with conditions like obesity, anxiety, and depression. But they also appear with sleep disturbances like limb movement disorders and if you use substances.  And its signs and symptoms look a bit different. 

• Nighttime eating without being hungry or thirsty.
• Eating foods you shouldn’t and non-foods.
• No anorexia.

If you have a sleep-related eating disorder, your healthcare provider may treat your sleep disorder first. Strategies like proper stress management, managing your sleep environment, and moving foods may help with your nighttime eating.

Mental Health Conditions

At this point, you know mental health conditions like depression and anxiety are comorbid conditions. For some of you, having narcolepsy increases your risk for these conditions. To begin to see this connection, you have to consider the effects narcolepsy has on your life. However, anxiety and depression aren’t the only conditions linked to narcolepsy. Though rare, it’s also possible to have schizophrenia and narcolepsy.

Schizophrenia is a serious condition that causes people to have trouble determining what is and isn’t reality. These signs and symptoms are traits of schizophrenia.

We don’t know it happens. But, we think it happens for one of these reasons. One, narcolepsy occurs with schizophrenia for some of you. Two, your narcolepsy medications are to blame. Or three, schizophrenia may be a psychotic form of narcolepsy.

• Hallucinations. 
• Sleep problems and poor sleep habits. 
• Abnormal responses to social situations.

Your healthcare provider may recommend medications that stimulate your nervous system and work for mental health conditions.

Obesity

Obesity is another comorbid condition of narcolepsy. There’s a difference between being overweight and being obese, though both can affect your health. Obesity is a condition where people have too much body fat. Your BMI looks at your weight relative to your height and tells your percentage of body fat. Anything over 25% is considered obese.

People with narcolepsy are at risk for obesity. But, it seems that obesity occurs more in people with type 1 narcolepsy. We’re not sure why this is, but it seems that there’s a connection between excessive daytime sleepiness and higher BMIs. We also think that obesity may contribute to other comorbid conditions, like sleep apnea and diabetes. The best way to manage your obesity is through weight loss.

REM Sleep Behavior Disorder

Narcolepsy is a REM sleep disorder. So it should come as no surprise that a sleep behavior disorder appears as a comorbid condition for some of you. What comes to mind when you hear sleep behavior disorders? Did you think that it means muscle loss while sleeping? What about kicking, punching, or shouting in response to your dreams while sleeping? If you did, you’re right! Together, they make up REM sleep behavior disorders. You’ll have one or more of these symptoms.

• Sleep problems.
• Loss of muscle tone while sleeping. 
• Acting out your dreams.
• Harmful behaviors while sleeping.

We don’t know why sleep behavior disorders happen in people with narcolepsy. But, we know it’s secondary to your narcolepsy. We also think that it may have something to do with the neurotransmitters that regulate your sleep-wake cycles. Melatonin treatment before bedtime may help with your sleep behavior disorder.

Diabetes

Having narcolepsy increases your risk of having diabetes as a comorbid condition. We’re not sure why this happens, but different possibilities involve your brain’s protein deficiency. The same protein that regulates your sleep-wake cycle also alters your food intake and slows down your metabolism. This can lead to obesity, which you know can cause other health complications. That same protein deficiency can also cause insulin sensitivity, which leads to obesity and diabetes.

Diabetes is a condition that affects your body’s blood sugar levels. Your body converts the foods you eat into glucose (blood sugar) and fuel for your body. But, your body needs insulin to do that. Insulin is a hormone that makes it possible for your body to convert food into glucose. It also regulates your glucose levels. However, diabetes makes it hard for your body to do this.

• Frequent thirst and urination.
• Hunger.
• Fatigue.
• Blurred vision.

Manage your diabetes with insulin therapy and through diet and exercise.