While no clear link has been established between autism spectrum disorder and narcolepsy, shared neurological pathways may underlie overlapping symptoms and dual diagnosis.

Narcolepsy is a neurological disorder that affects your sleep-wake cycles. It features excessive daytime sleepiness (EDS), sleep paralysis, hypnagogic hallucinations, and, depending on the narcolepsy subtype, a sudden loss of muscle tone called “cataplexy.”

Autism spectrum disorder (ASD), often referred to simply as “autism,” is a common neurodevelopmental disorder. It’s caused by changes in your brain’s structure and function that affect development during childhood. Challenges with social interaction and communication, as well as repetitive and restrictive behaviors, are core symptoms of ASD.

The exact commonality of narcolepsy in ASD isn’t clear, though research suggests these conditions may frequently exist together.

A small study from 2021, for example, found that 40% of children who had narcolepsy also reported autistic traits or a formal diagnosis of their condition as ASD.

Because of limited studies and small sample groups, more research is necessary to determine a large-scale, accurate representation of narcolepsy and co-occurring (comorbid) ASD.

Narcolepsy symptoms

Narcolepsy’s primary symptom is EDS, which causes irresistible urges to sleep during your waking hours. All people with narcolepsy experience this symptom.

Other signs and symptoms of narcolepsy can include:

  • Cataplexy: Cataplexy is a sudden loss of muscle tone triggered by strong emotions that’s typically related to type 1 narcolepsy.
  • Hypnagogic hallucinations: These hallucinations occur during the hypnagogic sleep stage when you’re transitioning between sleeping and waking.
  • Sleep paralysis: Sleep paralysis is characterized by an inability to move or speak while falling asleep or waking.
  • Fragmented sleep or insomnia: Sleep can become disrupted by disturbances such as vivid dreaming, acting out, or sleep apnea.
  • Automatic behaviors: These behaviors include unconscious movements or actions that continue while experiencing a strong urge to sleep (spontaneous sleep episode).

Research suggests narcolepsy is frequently experienced in ASD. Additionally, traits common in ASD have been found to appear in narcolepsy. These shared traits are known as “narcolepsy personality.”

Narcolepsy personality has been used in literature to collectively describe experiences such as:

  • limited attention
  • introversion
  • feelings of inferiority
  • irritability
  • limited emotional regulation
  • shifts in mood
  • impaired social function

According to a scientific paper from 2023, narcolepsy personality is usually seen in type 1 narcolepsy, previously known as “narcolepsy with cataplexy.” Cataplexy, a sudden loss of muscle tone triggered by strong emotions, is typically, but not always, related to low levels of the brain hormone called “hypocretin.”

Under this theory, hypocretin dysfunction plays an important role in why ASD, narcolepsy, and sleep challenges can feature overlapping symptoms and may occur together.

Is sleepiness a symptom of ASD?

Sleepiness itself isn’t a diagnostic symptom of ASD, but it can be part of your ASD experience. Sleep disturbances in ASD can naturally lead to sleepiness from fragmented or unrefreshing slumber overnight.

Feeling overstimulated or overwhelmed can also lead to feelings of fatigue in ASD. When sleepiness is persistent or excessive, you may have a co-occurring sleep disorder.

ASD is often comorbid with sleep challenges, with 50–80% of autistic children and autistic adolescents experiencing sleep disturbances.

In a 2020 literature review, researchers theorized that ASD pathology involves dysfunction of hypocretin, a hormone that’s also implicated in sleep-wake dysregulation and an essential diagnostic component of narcolepsy.

Narcolepsy and ASD are separate diagnoses with different support approaches. If you live with them comorbidly, your supportive strategies will involve individualized therapies that take into account how these conditions jointly affect your everyday life.

Autistic people are primarily supported with helpful therapies. You may use occupational therapy, speech therapy, and behavioral therapy to help you develop new skills and coping strategies for day-to-day life.

Treatment for narcolepsy typically involves medications to help improve EDS and other symptoms. Lifestyle changes, like structured sleep habits and regular exercise, may help create the foundation for improved sleep overall.

When you live with comorbid ASD and narcolepsy, supportive strategies often overlap. Both ASD and narcolepsy, for example, can benefit from improved sleep practices, also known as “sleep hygiene.”

Behavioral programs and psychotherapy options can help you navigate the individual needs of ASD while proactively managing narcolepsy symptoms.

Your support plan will be customized to meet your individual needs in both conditions.

Narcolepsy and ASD are separate diagnoses that can share overlapping symptoms. Although the exact widespread commonality of their comorbidity isn’t known, limited research suggests they may have a high rate of co-occurrence.

While ASD and narcolepsy have separate supportive approaches, many of their therapies can overlap. Tailored behavioral programs and lifestyle changes, for example, can help manage both ASD and narcolepsy in everyday life.