Narcolepsy and Insomnia: What’s the Link?

Narcolepsy and insomnia are sleep disorders. One possible cause of both conditions is how much of the chemical messenger orexin a person makes. Insomnia could mean they have too much – or an inappropriate release – of orexin at night, while someone with narcolepsy may not have enough.

Narcolepsy is associated with “sleep attacks” that can occur at unexpected times, such as while walking or doing other physical activities. Episodes of sudden sleep, excessive daytime sleepiness, and sudden muscle weakness are characteristic of narcolepsy. There are two types of narcolepsy: type 1 and type 2.

Insomnia also causes excessive daytime sleepiness and is characterized by an inability to fall asleep or stay asleep. It can also cause a person to wake up early in the morning, several hours earlier than necessary. Someone with insomnia may struggle with functional impairment during the day due to lack of sleep.

This article examines whether a person can have both narcolepsy and insomnia, the relationship between the two, similarities and differences, and how each condition is treated.

Narcolepsy and insomnia have a chemical messenger called orexin in common. This peptide plays a role in activating parts of the brain that promote wakefulness.

People with narcolepsy may have fewer than normal nerve cells producing orexin, while people with insomnia may have too much orexin or an inappropriate release of orexin at night. Too little orexin can cause drowsiness, and too much can lead to insomnia.

It is also possible for a person with narcolepsy to experience insomnia as one of their symptoms. In these cases, a person with too little orexin may also experience insomnia.

A person can have both narcolepsy and insomnia. While the two conditions represent opposite ends of the spectrum of sleep disorders, a person with narcolepsy – which can experience extreme fatigue during the daytime – will also typically have difficulty sleeping through the night. People with narcolepsy may have other sleep disorders such as insomnia, sleep apnea, and vivid dreaming.

Insomnia and narcolepsy share some common symptoms, such as excessive daytime sleepiness. Both conditions can lead to concentration and performance problems during the day due to fatigue. However, they also differ in several points, which we will outline below.


  • Narcolepsy is a rare, long-term brain that causes a person to fall asleep suddenly, often at inappropriate times.
  • Narcolepsy can cause cataplexy – a temporary loss of control of muscles that can lead to weakness and collapse. This often happens in response to a person showing strong emotions, such as during an outburst of anger or laughing. Cataplexy narcolepsy is type 1 narcolepsy. Narcolepsy without cataplexy is type 2.
  • Narcolepsy causes sleep attacks in which a person suddenly falls asleep without warning.
  • Narcolepsy can cause vivid – known as hypnagogic hallucinations on falling asleep and hypnopompic hallucinations on waking.
  • Narcolepsy can cause sleep paralysis, a temporary inability to speak or move while falling asleep or waking up.
  • Narcolepsy is caused by a lack of orexin, a chemical in the brain that regulates wakefulness.
  • People with narcolepsy generally fall asleep quickly, but may wake up spontaneously several times during the night and have difficulty getting back to sleep. This insomnia seems paradoxical in a characterized by daytime sleepiness and may be due to a person having a low sleep-waking threshold.


  • Insomnia is a condition that makes it difficult for people to fall asleep and stay asleep on a regular basis.
  • Insomnia can cause a person to wake up all night.
  • Insomnia can cause a person to wake up too early.
  • Insomnia can lead to fatigue even after you sleep.
  • Insomnia can cause irritability and fatigue throughout the day.

A doctor can treat narcolepsy and insomnia differently. If insomnia is a symptom of narcolepsy, treating narcolepsy can help reduce insomnia.

Treatment of narcolepsy

There is no cure for narcolepsy. However, a person may be able to manage the condition by changing their sleeping habits and taking medication.

A person can try:

  • Take short naps often throughout the day
  • on a strict sleeping schedule and going to bed at the same time
  • Creating a good sleeping environment, e.g. B. a quiet, comfortable room with no distractions
  • Avoiding caffeine and alcohol before bed
  • Relax before bed

A doctor may prescribe drugs for narcolepsy. This may include stimulants like dexamphetamine, methylphenidate, or modafinil to combat excessive daytime sleepiness. Non-sedating antidepressants like citalopram or fluoxetine can help with some of the possible symptoms that may accompany narcolepsy, including cataplexy. Sodium oxybate can treat both excessive daytime sleepiness and cataplexy.

Treatment of insomnia

As with narcolepsy, people with insomnia should try to practice good sleeping habits, such as sleeping. B. Following a sleep schedule, relaxing before bed, and creating a good sleeping environment.

Treatment can include:

Cognitive Behavioral Therapy (CBT)

CBT can help a person become less afraid of sleeping and develop more positive thinking.

Prescription drugs

These include melatonin receptor agonists, benzodiazepines, which can be habit forming, benzodiazepine receptor agonists, and orexin receptor antagonists such as suvorexant.

Over-the-counter (OTC) drugs

OTC drugs for insomnia are mainly antihistamines like diphenhydramine and doxylamine. Chronic use of antihistamines can be linked to dementia, so a person should tell their doctor about any OTC or natural treatments they are taking for insomnia.

Natural treatments

Natural treatments can include melatonin, lavender, magnesium, and valerian root.

Find out more about remedies for insomnia here.

Other possible causes of insomnia can include:

Certain medical conditions and medications used to treat these conditions can also cause insomnia:

Possible causes of narcolepsy can include:

  • Immune system problems: Many researchers suggest that an autoimmune process selectively kills orexin neurons. This results in lower orexin production, which leaves the brain less able to regulate sleep cycles. In addition, the occurrence of narcolepsy appears to be highest in spring, suggesting that a winter infection may be a trigger. Streptococcal pharyngitis is a possible infection – anti-streptococcal antibodies are sometimes elevated, especially in the first year after narcolepsy began.
  • Pandemrix vaccine: In 2013, researchers found a between narcolepsy and the flu vaccine Pandemrix in children. The vaccine was used during the 2009-2010 swine flu epidemic. The risk is minimal, however, with the chance of developing narcolepsy after vaccination estimated at 1 in 52,000.

Other triggers for narcolepsy can include:

  • a genetic problem that is inherited from the family
  • psychological stress
  • hormonal changes, e.g. B. in menopause or puberty
  • a change in sleep pattern

Some other conditions that can also be associated with hypersomnia and excessive daytime sleepiness include:

Obstructive sleep apnea: This is a common sleep characterized by interruptions in breathing while you sleep. This can lead to daytime sleepiness, irritability, poor concentration, loud snoring and difficulty sleeping.

Kleine Levin Syndrome: This is a rare condition in which a person requires excessive sleep, up to 20 hours a day. A person may also need to overeat and experience changes in behavior, such as an unusually uninhibited sex drive.

Idiopathic Hypersomnia (IH): This is a chronic condition characterized by episodes of extreme drowsiness and fatigue for no apparent reason. A person with IH does not experience cataplexy like type 1 narcolepsy.

A person with narcolepsy can also experience:

Although narcolepsy and insomnia are on opposite ends of the clinical spectrum, a person can have both disorders. Insomnia is sometimes a symptom of narcolepsy as well.

The two have the chemical orexin in common. People with insomnia may have inappropriate releases of orexin at night, which regulates wakefulness, while those with narcolepsy may underperform. There are also various other triggers for each condition.

Change to: “The two conditions both cause daytime sleepiness and fatigue, but also share differences. Narcolepsy – especially Type 1 – is characterized by cataplexy. Insomnia is usually characterized by difficulty falling asleep.

People with both sleep disorders can benefit from creating a healthy, comfortable sleeping environment and following a regular sleep schedule. A doctor can prescribe various medications to treat any condition.

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