Alcohol use doesn’t cause narcolepsy directly, but it may worsen daytime sleepiness. If you live with this sleep disorder, limiting alcohol use, mind-body interventions, and more may help with your symptoms.

Narcolepsy is a sleep disorder that involves excessive daytime sleepiness. If you have this condition, you may feel more tired than usual throughout the day and briefly fall asleep without meaning to. You may also experience a loss of muscle tone called cataplexy and hallucinations when you fall asleep or wake up.

Experts don’t fully understand yet the underlying causes of narcolepsy, but genetics, autoimmune disorders, and traumatic brain injury may all play a role.

Alcohol is not a confirmed cause of narcolepsy, but there may be a more indirect connection between the two. Read on to explore this potential link, plus get some guidance on managing your symptoms.

Some people who live with narcolepsy find that drinking alcohol can make some of their symptoms worse — perhaps due to alcohol’s sedating effects.

Both narcolepsy and alcohol can cause excessive daytime sleepiness. If you already experience sleepiness due to narcolepsy, alcohol may further depress your central nervous system function, creating an additional tranquilizing effect.

The link between narcolepsy and alcohol may run even deeper, as the same neurological pathway in your brain — the orexin (hypocretin) pathway — may factor into both conditions.

One 2020 rodent-based study explored why people living with alcohol use disorder (AUD) commonly have excessive daytime sleepiness. The researchers found that alcohol withdrawal decreased the expression of orexin.

Orexin, also called hypocretin, is a brain chemical that regulates your rapid eye movement sleep. Low levels of this hormone may make you feel extra sleepy during the day.

Decreased orexin, as a matter of fact, is one of the defining features of narcolepsy with cataplexy.

While experts have found links between AUD and increased levels of orexin, irregular levels of this hormone may still affect your sleep.

Case-specific alcohol-induced narcolepsy

Currently, no conclusive evidence points to alcohol as a cause of narcolepsy.

Individual case reports, including two examples published in 2012 and 2021, have examined the development of narcolepsy after long-term heavy alcohol use.

In these cases, researchers linked heavy alcohol use to the later development of narcolepsy. That said, they couldn’t determine whether participants already had undiagnosed narcolepsy or if the condition developed due to chronic depression of the central nervous system.

What about other substances?

If you have narcolepsy, other substances beyond alcohol can also make you feel sleepier.

For instance, drinking caffeine too close to bedtime can prevent you from getting a good night’s sleep, which may leave you extremely sleepy the next day.

Nicotine, another stimulant, can also disrupt the quality of your rest and worsen sleepiness the next day.

Alcohol may change how narcolepsy medication works in your body.

It’s generally a good idea to avoid using alcohol with any medication, since alcohol may make your medications less effective or, in some cases, toxic. Combining some medications with alcohol may also cause potentially life threatening side effects.

Alcohol is known to interact with common narcolepsy medications, including:

FYI

According to a 2016 Food and Drug Administration (FDA) warning, using alcohol while taking Xyrem — or any other medications that depress your central nervous system — could lead to death.

Other narcolepsy-specific drugs include pitolisant (Wakix) and solriamfetol (Sunosi). To date, evidence doesn’t point to any serious risks of drinking alcohol while taking these medications. That said, it’s important to ask your prescribing clinician if it’s safe to drink alcohol while taking any prescription medication.

Experts continue to explore possible causes of narcolepsy.

Orexin levels appear to play a major role, but not everyone with narcolepsy has low orexin.

Other possible causes include:

You may also have a greater chance of developing narcolepsy if you:

A medical doctor, psychiatrist, or psychologist can help determine if you have a sleep disorder.

If your care team believes you may have narcolepsy, they’ll likely recommend a sleep study and check your orexin levels.

Treatment for narcolepsy includes medications and lifestyle changes, such as:

Mind-body interventions may also help improve your symptoms. In fact, one small 2020 study found that meditation-relaxation therapy appeared to help reduce hallucinations and sleep paralysis associated with narcolepsy.

Other options include:

Support for alcohol use

If your symptoms feel worse when you drink alcohol and you’d like to make a plan to limit alcohol use, a therapist or another trained specialist can help.

The Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 can help you find a mental health professional in your area.

You can also get more support from organizations such as:

Alcohol use doesn’t cause narcolepsy. That said, since it has a sedative effect, it can make you feel sleepy all the same.

If you believe alcohol use might have an impact on your sleep or on your narcolepsy symptoms, a trained healthcare professional, therapist, or sleep specialist can offer more guidance and support.