Some common narcolepsy comorbidities include obstructive sleep apnea (OSA), attention deficit hyperactivity disorder (ADHD), restless legs syndrome (RLS), anxiety, and depression.
Comorbidities are conditions that occur at the same time. Sometimes, this is because they have a shared root cause or shared risk factors. In other cases, one condition may lead to the other.
Read on to learn more about narcolepsy comorbidities, their symptoms, and treatments.
List of narcolepsy comorbidities
Narcolepsy is a rare neurological condition that can occur or overlap with many other conditions.
A 2023 study found that some of the most common narcolepsy comorbidities include:
- OSA
- depression
- anxiety
- ADHD
- RLS
- insomnia
- pain disorders, such as fibromyalgia
- migraine
- asthma
- irritable bowel syndrome
- cervical spondylosis
- hypothyroidism
- metabolic conditions, such as type 2 diabetes, obesity, high blood pressure, and high cholesterol
- cardiovascular disease
Below, find out how some of these conditions interact with narcolepsy.
OSA
Narcolepsy can occur as a complication of OSA. This condition leads to pauses in breathing while a person is asleep.
A 2021 review of past research suggests that 45.6% more people with narcolepsy have OSA than those without narcolepsy. A high BMI is a risk factor for both conditions.
Additionally, some scientists theorize that changes to the IRFD1 gene may elevate the risk of OSA and narcolepsy.
Symptoms of OSA include:
- loud, disruptive snoring
- choking, gasping, or spluttering sounds during sleep
- fragmented sleep or frequent awakenings
- low oxygen levels
- daytime sleepiness
As with narcolepsy, OSA can affect a person’s:
- sleep quality
- alertness
- ability to focus
- mental well-being
- cardiovascular health
- safety when driving or doing other daily activities
Options for reducing OSA include weight management, devices that keep the person on their side while asleep, and continuous positive airway pressure, which keeps the airways open during sleep.
RLS
People with RLS have an irresistible urge to move their lower limbs. This feeling often appears or gets worse during the night, making it hard to relax and sleep.
The same 2021 review of past research suggests that 4.9% more people with narcolepsy have RLS than is typical, and that 3.7% more have periodic limb movement disorder (PLMD).
In PLMD, the limbs twitch and jerk every 20 to 40 seconds during sleep. The movements can disrupt sleep, but most people do not realize that they are doing them.
To manage these conditions, a doctor may:
- review any medications that may be causing symptoms
- suggest dietary changes, such as avoiding caffeine
- prescribe medications
Mental health conditions
Anxiety, depression, and other mental health conditions are common in those with narcolepsy.
In comparison with the general population, 13.2% more people with narcolepsy have an anxiety disorder, and 24.1% more have a mood disorder.
A 2023 report suggests that as many people with narcolepsy have depression as the rest of the population, and that this comorbidity is especially high in young people with the condition.
These high rates of mood disorders could stem from changes in neurotransmitters known as hypocretins. Hypocretins stabilize the levels of other neurotransmitters involved in sleep, including serotonin, noradrenaline, and dopamine.
Another explanation is that narcolepsy can significantly affect a person’s quality of life, which may affect their mood and well-being.
Other mental health conditions that have a link with narcolepsy include psychotic conditions, such as schizophrenia and schizoaffective disorder. A 2020 study suggests that they may share some underlying mechanisms, but more research is necessary.
Treatment for many mental health conditions usually involves talk therapy, medication, or both.
Anyone experiencing narcolepsy alongside another condition should let their doctor know so that they can make the right decisions about medication. This can help prevent drug interactions that could worsen either condition.
ADHD
ADHD and narcolepsy can have some of the same symptoms, such as:
- difficulty focusing
- insomnia
- restlessness
As a result, doctors sometimes misdiagnose narcolepsy as ADHD in children. However, some research also suggests that there is a link between ADHD and narcolepsy, and that they often occur together.
A 2024 review and meta-analysis of previous studies found that 25% of people with narcolepsy also have ADHD. It is also worth noting that some off-label drugs for narcolepsy are also ADHD medications.
Research into the possible link between these conditions is ongoing.
Weight gain
Some evidence suggests a link between weight gain and narcolepsy — specifically type 1 narcolepsy.
For example, a 2022 study mentions previous research that found that 50% of children with narcolepsy had excess weight or obesity at the time of diagnosis, and that over 80% experienced rapid weight gain after the symptoms of narcolepsy appeared. This suggests that narcolepsy itself may contribute to weight gain.
One possible explanation is that type 1 narcolepsy involves autoimmune attacks on hypocretin cells, which play a role in the sleep-wake cycle, eating behavior, and energy use.
Eating disorders
Some research suggests that eating disorders are more common in people with narcolepsy.
A 2024 study found that eating disorders were more frequent and more severe in people who have narcolepsy with cataplexy.
Night eating syndrome was also more prevalent in those with narcolepsy, and it was linked to higher levels of insomnia and lower sleep quality.
Night eating syndrome occurs when a person wakes frequently in the night and feels as though they have to eat in order to get back to sleep.
As with weight gain, an association between narcolepsy and eating disorders could stem from changes in hypocretin activity. However, more research is needed to confirm a link between the two.
Summary
Narcolepsy is a neurological condition and sleep disorder that involves broken sleep, daytime sleepiness, sleep attacks, and other symptoms.
It can have a severe effect on a person’s quality of life and may occur with a range of other conditions, including depression and weight gain.
Experts are looking for underlying links that could tie narcolepsy to these other conditions.
