Living with Narcolepsy: Current Management Strategies, Future Prospects, and Overlooked Real-Life Concerns

Area of Science:

• Neurology
• Sleep Medicine
• Pharmacology

Background:

• Narcolepsy is a chronic neurological disorder impacting the sleep-wake cycle, characterized by excessive daytime sleepiness (EDS) and cataplexy.
• Hypocretin/orexin system dysfunction is the suspected cause of narcolepsy with cataplexy.
• Diagnosis delays are common due to underrecognition and complex testing, with symptom onset typically between ages 10-35.

Purpose of the Study:

• To summarize current and prospective pharmacological therapies for narcolepsy.
• To discuss treatment considerations for specific populations, including children and reproductive-age women.
• To review the impact of health-related stigma and efforts to address it.

Main Methods:

• Literature review of current and emerging pharmacological treatments for narcolepsy.
• Analysis of treatment efficacy, side effects, and management challenges.
• Exploration of psychosocial aspects and stigma associated with narcolepsy.

Main Results:

• Recent approvals include solriamfetol and pitolisant for adults, and expanded use of sodium oxybate for children.
• Current treatments can improve daytime functioning but may have side effects or limited efficacy, leading to residual impairment.
• Patient-centered research and new diagnostic/therapeutic options are under development.

Conclusions:

• Despite treatment advances, suboptimal symptom management and psychosocial impacts remain significant concerns in narcolepsy.
• Addressing health-related stigma is crucial for improving the overall well-being of individuals with narcolepsy.
• Ongoing research and development promise enhanced diagnostic and therapeutic strategies for narcolepsy.