Narcolepsy pp 239-247 | Cite as

Narcolepsy and Mental Health



There are methodological difficulties in assessing cognitive function in narcolepsy, but despite these it appears that there is a defect in maintenance of attention, which is more significant than the problems with memory. The subject’s perception of memory loss is however greater than what can be demonstrated objectively. There may also be a generalised executive dysfunction unrelated to attention and memory deficits. Anxiety and depression are common, particularly in younger subjects. Psychosis is usually drug-induced, particularly by amphetamines. The realistic dreams and hypnagogic hallucinations should be distinguished from schizophrenia and REM sleep behaviour disorder.

There is considerable functional impairment due to the symptoms of narcolepsy with reduced quality of life, particularly in the domains of vitality and physical roles. Changes with age are probably important, but there are only few differences between the genders. Education, performance at work, social and recreational activities are all impaired by narcolepsy, but attention to lifestyle aspects and treatment with modern drugs, particularly modafinil and sodium oxybate, can improve functional capacity.


Narcolepsy Mental health Cognitive function Attention Memory Depression Quality of life Modafinil Sodium oxybate 


  1. 1.
    Schneider C, Fulda S, Schulz H. Daytime variation in performance and tiredness/sleepiness ratings in patients with insomnia, narcolepsy, sleep apnea and normal controls. J Sleep Res 2004;13:373–383CrossRefPubMedGoogle Scholar
  2. 2.
    Hood B, Bruck D. Sleepiness and performance n narcolepsy. J Sleep Res 1996;5:128–134CrossRefPubMedGoogle Scholar
  3. 3.
    Pollak CP, Wagner DR, Moline ML, et al. Cognitive and motor performance of narcoleptic and normal subjects living in temporal isolation. Sleep 1992;15:202–211PubMedGoogle Scholar
  4. 4.
    Valley V, Broughton R. Daytime performance deficits and physiological vigilance n untreated patients with narcolepsy-cataplexy compared with controls. Rev EEG Neurophysiol 1981;11:133–139Google Scholar
  5. 5.
    Schulz H, Wilde-Frenz J. The disturbance of cognitive processes in narcolepsy. J Sleep Res 1995;4:10–14CrossRefPubMedGoogle Scholar
  6. 6.
    Rieger M, Mayer G, Gauggel S. Attention deficits in patients with narcolepsy. Sleep 2003;26:36–43PubMedGoogle Scholar
  7. 7.
    Naumann A, Bellebaum C, Daum I. Cognitive deficits in narcolepsy. J Sleep Res 2006;15:329–338CrossRefPubMedGoogle Scholar
  8. 8.
    Godbout R, Montplaisir J. All-day performance variations in normal and narcoleptic subjects. Sleep 1986;9:200–204PubMedGoogle Scholar
  9. 9.
    Broughton RJ, Ghanem Q, Hishikawa Y, et al. Life effects of narcolepsy in 180 patients from North America, Asia and Europe compared to matched controls. Can J Neurol Sci 1981;8:299–304PubMedGoogle Scholar
  10. 10.
    Smith KM, Merritt SL, Cohen FL. Can we predict cognitive impairments in persons with narcolepsy? Loss Grief Care 1992;5:103–113Google Scholar
  11. 11.
    Aguirre M, Broughton R, Stuss D. Does memory impairment exist in narcolepsy-cataplexy? J Clin Exp Neuropsychol 1985;7:14–24CrossRefPubMedGoogle Scholar
  12. 12.
    Rogers AE, Rosenberg RS. Tests of memory in narcoleptics. Sleep 1990;13:42–52PubMedGoogle Scholar
  13. 13.
    Henry GK, Satz P, Heilbronner RL. Evidence of a perceptual-encoding deficit in narcolepsy? Sleep 1993;16:123–127Google Scholar
  14. 14.
    Hood B, Bruck D. Metamemory in narcolepsy. J Sleep Res 1997;6:205–210CrossRefPubMedGoogle Scholar
  15. 15.
    Fulda S, Schulz H. Cognitive dysfunction in sleep disorders. Sleep Med Rev 2001;5:423–445CrossRefPubMedGoogle Scholar
  16. 16.
    Naumann A, Daum I. Narcolepsy: pathophysiology and neuropsychological changes. Behav Neurol 2003;14:89–98PubMedGoogle Scholar
  17. 17.
    Stores G. The protean manifestations of childhood narcolepsy and their misinterpretation. Dev Med Child Neurol 2006;48:307–310CrossRefPubMedGoogle Scholar
  18. 18.
    Daniels E, King MA, Smith IE, Shneerson JM. Health-related quality of life in narcolepsy. J Sleep Res 2001;10:75–81CrossRefPubMedGoogle Scholar
  19. 19.
    Dodel R, Peter H, Walbert T , Spottke A, Noelker C, Berger K, Siebert U, Oertel WH, Kesper K, Becker HF, Mayer G. The socioeconomic impact of narcolepsy. Sleep 2004;27:1123–1128PubMedGoogle Scholar
  20. 20.
    Stores G, Montgomery P, Wiggs L. The psychosocial problems of children with narcolepsy and those with excessive daytime sleepiness of uncertain origin. Pediatrics 2006;e1116–e1123Google Scholar
  21. 21.
    Shneerson JM, Myers AJ, Morrish E. Factors determining quality of life in narcolepsy. In preparationGoogle Scholar
  22. 22.
    Vourdas A, Shneerson JM, Gregory CA, Smith IE, King MA, Morrish E, McKenna PJ. Narcolepsy and psychopathology: is there an association? Sleep Med 2002;3:353–360CrossRefPubMedGoogle Scholar
  23. 23.
    Fosse R, Stickgold R, Hobson JA. Emotional experience during rapid-eye-movement sleep in narcolepsy. Sleep 2002;25:724–730PubMedGoogle Scholar
  24. 24.
    Schenck CH, Mahwold MW. REM sleep behavior disorder: Clinical, developmental and neuroscience perspectives 16 years after its formal identification in sleep. Sleep 2002;25:120–138PubMedGoogle Scholar
  25. 25.
    Ervik S, Abdelnoor M, Heier MS, Ramberg M, Strand G. Health-related quality of life in narcolepsy. Acta Neurol Scand 2006;e114:198–204Google Scholar
  26. 26.
    Dodel R, Peter H, Spottke A, Noelker C, Althaus A, Siebert U, Walbert T, Kesper K, Becker HF, Mayer G. Health-related quality of life in patients with narcolepsy. Sleep Med 2007;8:733–741CrossRefPubMedGoogle Scholar
  27. 27.
    Shneerson JM, Dauvilliers Y, Garcia-Borreguero D, Plazzi G. The impact of narcolepsy and its treatment – a European Study. Eur J of Neurol 2008 submitted for publicationGoogle Scholar
  28. 28.
    Vignatelli L, D’Alessandro R, Mosconi P, Ferini-Strambi L, Guidolin L, De Vincentiis A, Plazzi G. Health-related quality of life in Italian patients with narcolepsy: the SF-36 health survey. Sleep Med 2004;5:467–475CrossRefPubMedGoogle Scholar
  29. 29.
    Beusterien KM, Rogers AE, Walsleben JA, et al. Health-related quality of life effects of modafinil for treatment of narcolepsy. Sleep 1999;6:757–765Google Scholar
  30. 30.
    Lamphere J, Young D, Roehrs T, et al. Fragmented sleep, daytime somnolence and age in narcolepsy. Clin Electroencephalogr 1989;20:49–54PubMedGoogle Scholar
  31. 31.
    Quinnell TQ, Smith IE, Shneerson JM. Impact of age on narcolepsy: evidence for an accelerated decline in nocturnal sleep quality. J Clin Sleep Med 2008 submitted for publicationGoogle Scholar
  32. 32.
    Wittig R, Zorick F, Piccione P, Sicklesteel J, Roth T. Narcolepsy and disturbed nocturnal sleep. Clin Electroencephalogr 1983;14:130–134PubMedGoogle Scholar
  33. 33.
    Dauvilliers Y, Pennestri M-H, Petit D, Dang-Vu T, Lavigne G, Montplaisir J. Periodic leg movements during sleep and wakefulness in narcolepsy. J Sleep Res 2007;16:333–339CrossRefPubMedGoogle Scholar
  34. 34.
    Billiard M, Besset A, Cadilhac J. The clinical and polygraphic development of narcolepsy. In: Guilleminault C, Lugaresi E, eds. Sleep/wake disorders: natural history, epidemiology, and long-term evolution. New York: Raven, 1983:171–185Google Scholar
  35. 35.
    Passouant P, Billiard M. The evolution of narcolepsy with age. In: Guilleminault C, Dement WC, Passouant P, eds. Narcolepsy. New York: Spectrum, 1976;176–196Google Scholar
  36. 36.
    Rosenthal LD, Merlotti L, Young DK, et al. Subjective and polysomnographic characteristics of patients diagnosed with narcolepsy. Gen Hosp Psychiatry 1990;191–197Google Scholar
  37. 37.
    Dauvilliers Y, Gosselin A, Paquet J, et al. Effect of age on MSLT results in patients with narcolepsy-cataplexy. Neurology 2004;61:46–50Google Scholar
  38. 38.
    Nevsimalova S, Vankova J, Pretl M, Bruck D. Narkolepsie v detsckem a adolescentnim veku-klinicke a psychosocialni aspekty. Ces a slov Neurol Neurochir 2002;3:169–174Google Scholar
  39. 39.
    Wise MS. Childhood narcolepsy. Neurology 1998;50:S37–S42PubMedGoogle Scholar
  40. 40.
    Goswami M. The influence of clinical symptoms on quality of life in patients with narcolepsy. Neurology 1998;50:S31–S36PubMedGoogle Scholar
  41. 41.
    Zwicker J, Bruck D, Parkes JD, et al. Acute mood improvement after amphetamine and methylphenidate in narcolepsy. J Sleep Res 1995;4:252–255CrossRefPubMedGoogle Scholar
  42. 42.
    Schwartz JRL, Nelson MT, Schwartz ER, et al. Effects of modafinil on wakefulness and executive function in patients with narcolepsy experiencing late-day sleepiness. Clin Neuropharmacol 2004;27:74–79CrossRefPubMedGoogle Scholar
  43. 43.
    Shneerson J, Randall D, Cafferty F, et al. Treatment with modafinil may have beneficial effects on planning ability and mood in patients with excessive daytime sleepiness: findings from a pilot study. J Sleep Res 2006;15:P029Google Scholar
  44. 44.
    Saletu M, Anderer P, Semlitsch HV, et al. Low-resolution brain electromagnetic tomography (LORETA) identifies brain regions linked to psychometric performance under modafinil in narcolepsy. Psychiatry Res 2007;154:69–84Google Scholar
  45. 45.
    Becker PM, Schwartz JRL, Feldman NT, Hughes RJ. Effect of modafinil on fatigue, mood, and health-related quality of life in patients with narcolepsy. Psychopharmacology 2004;171:133–139CrossRefPubMedGoogle Scholar
  46. 46.
    The Xyrem® International Study Group. A double-blind, placebo-controlled study demonstrates sodium oxybate is effective for the treatment of excessive daytime sleepiness in narcolepsy. J Clin Sleep Med 2005;1:391–397Google Scholar
  47. 47.
    The US Xyrem® Multicenter Study Group. A randomized, double blind, placebo-controlled multicenter trial comparing the effects of three doses of orally administered sodium oxybate with placebo for the treatment of narcolepsy. Sleep 2002;25:42–49Google Scholar
  48. 48.
    Weaver TE, Cuellar N. A randomized trail evaluating the effectiveness of sodium oxybate therapy on quality of life in narcolepsy. Sleep 2006;29:1189–1194PubMedGoogle Scholar
  49. 49.
    Hayduk R, Mitler A. Sodium oxybate therapy improves the quality of life of narcolepsy patients. Sleep 2001;24:A326Google Scholar

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Respiratory Support and Sleep CentrePapworth HospitalPapworth EverardUK

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