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Advancements in the understanding of narcolepsy are happening. Register for updates »

The Impact of the COVID-19 Pandemic on Your Patients Living With Narcolepsy

Your patients’ narcolepsy symptoms may have changed as a result of the pandemic.

Risk mitigation strategies in the pandemic may have caused people living with narcolepsy to alter their routines.1,2 As a result, these patients may experience worsening symptoms and quality of life.1 Excessive daytime sleepiness is most likely to occur in monotonous situations, which may be encountered more frequently in people who are working from home or attending school virtually.3-5

Studies suggest that a majority of people living with narcolepsy have enhanced behavioral strategies (e.g., increasing the duration of nocturnal sleep time and the frequency of daytime napping) during quarantine, which may help alleviate excessive daytime sleepiness.2 Even after the pandemic ends, it is likely that remote learning and working will continue into the future and impact people living with narcolepsy.3,4,6

It is important to reassess patients for symptoms that may not be fully under control in this new environment and to reevaluate management strategies as needed.


Consider recommending behavioral strategies to your patients with narcolepsy to help manage their symptoms, including7:

COVID 19 icons naps

Taking short naps

COVID 19 icons sleep schedule

Maintaining a regular sleep schedule

COVID 19 icons avoid caffeine

Avoiding caffeine or alcohol before bed

COVID 19 icons avoid smoking

Avoiding smoking

COVID 19 icons exercise daily

Exercising daily

COVID 19 icons avoid meals before bedtime

Avoiding large, heavy meals right before bedtime

Telemedicine is a convenient alternative to in-office visits for chronic disorderslike narcolepsy.8

Telemedicine provides many benefits for both patients and providers: it can help alleviate geographic barriers to high-quality sleep care and can help increase regular clinical follow-up. Telemedicine has a successful history in sleep medicine, and its convenience may prove especially valuable for long-term management of chronic disorders like narcolepsy.8 A 2020 study in patients with narcolepsy has shown that adjunctive cognitive behavioral therapy using telehealth helped improve psychosocial functioning.9

Know What to Expect From Telemedicine

Share this checklist with your patients with narcolepsy to help them get the most out of their appointments.

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Know What to Expect From Telemedicine

Guide to Telemedicine
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  1. Aguilar ACR, Frange C, Huebra L, Gomes ACD, Tufik S, Coelho FMS. The effects of the COVID-19 pandemic on patients with narcolepsy. J Clin Sleep Med. 2020. doi: 10.5664/jcsm.8952.
  2. Postiglione E, Pizza F, Ingravallo F, et al. Impact of COVID-19 pandemic lockdown on narcolepsy type 1 management. Brain Behav. 2021;11(1):e01955. doi: 10.1002/brb3.1955.
  3. Camargo CP, Tempski PZ, Busnardo FF, Martins MdA, Gemperli R. Online learning and COVID-19: a meta-synthesis analysis. Clinics. 2020;75:e2286. doi: 10.6061/clinics/2020/e2286.
  4. Lopez-Leon S, Forero DA, Ruiz-Diaz P. Recommendations for working from home during the COVID-19 pandemic (and beyond). Work. 2020;66(2):371-375.
  5. American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.
  6. Mukhopadhyay S, Booth A, Calkins S, et al. Leveraging technology for remote learning in the era of COVID-19 and social distancing. Arch Pathol Lab Med. 2020;144(9):1027-1036.
  7. Narcolepsy Fact Sheet. National Institute of Neurological Disorders and Stroke. Updated September 30, 2020. Accessed March 4, 2020.
  8. Watson NF, Rosen IM, Chervin RD. The past is prologue: the future of sleep medicine. J Clin Sleep Med. 2017;13(1):127-135.
  9. Ong J, Dawson S, Mundt J, Moore C. Developing a cognitive behavioral therapy for hypersomnia using telehealth: a feasibility study. J Clin Sleep Med. 2015;16(12):2047-2062.

Performance of routine tasks without awareness.

Sudden and brief loss of muscle tone, often triggered by strong emotions or certain situations. Narcolepsy with cataplexy is known as narcolepsy type 1.

Complete collapse to the ground; nearly all skeletal muscles are involved.

Only certain muscle groups are involved.

Biological clock mechanism that regulates the 24-hour cycle in the physiological processes of living beings. It is controlled in part by the SCN in the hypothalamus and is affected by the daily light-dark cycle.

Frequent awakenings and inappropriate transitions between states of sleep and wakefulness during nighttime sleep.

The inability to stay awake and alert during the day.

A neurotransmitter in the brain that supports wakefulness.

Vivid, realistic, and sometimes frightening dream-like events that occur when falling asleep.

Also known as orexin. A neuropeptide that supports wakefulness and helps suppress non-REM sleep and REM sleep.

Primary brain region for regulating the timing of sleep-wake states.

Unintentionally falling asleep due to excessive daytime sleepiness. Also known as “sleep attacks.”

Brief, unintentional lapses into sleep or loss of awareness.

A validated objective measure of the tendency to fall asleep in quiet situations.

People living with narcolepsy type 1 have low levels of hypocretin.

Narcolepsy without cataplexy; the cause of narcolepsy type 2 is unknown.

A state of sleep characterized by slower-frequency, more synchronized neuronal activity and decreased muscle tone. Deep stages help to restore the body.

A multiparameter test that monitors physiologic signals during sleep; used as a diagnostic tool in sleep medicine.

A state of sleep characterized by fast-frequency, desynchronized activity on EEG, vivid dreams, and loss of muscle tone. Normally occurs 60-90 minutes after sleep onset. Also known as “paradoxical sleep.”

Brief loss of control of voluntary muscles with retained awareness at sleep-wake transitions.

Sleep-onset REM period.

The VLPO as well as the median preoptic nucleus (MnPO) are located in the hypothalamus and contain essential neurons for promoting non-REM sleep. These neurons project to all wake-promoting regions to inhibit wakefulness and promote non-REM sleep during the night.8,11 Neurons in the extended VLPO mediate the promotion of REM sleep by inhibiting certain wake-promoting neurons that suppress REM sleep.8