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Cognitive Behavioral Therapy for Narcolepsy

Posted on November 11, 2021
Medically reviewed by
Allen J. Blaivas, D.O.
Article written by
Brooke Dulka, Ph.D.

Cognitive behavioral therapy (CBT) has been extensively studied in the field of psychology and psychiatry and is one of the more popular forms of mindfulness-centered therapies for conditions like depression, anxiety, and chronic pain. CBT has also been found to be particularly helpful for many conditions when it is used alongside medication. It can be done in a group therapy setting or one-on-one with a trained psychologist or counselor. But how can CBT help people with narcolepsy?

CBT and Mindfulness

CBT uses mindfulness at its core. The concept of mindfulness has its roots in Eastern contemplative traditions (such as Hinduism and Zen Buddhism) and is associated with the formal practice of mindfulness meditation. Mindfulness is a mental state achieved by maintaining your awareness on the present moment, while calmly acknowledging and accepting your feelings, thoughts, and bodily sensations.

CBT involves efforts to change thinking patterns and behavior tendencies. Being mindful of how you react in certain situations can greatly assist in modifying unhealthy behaviors. CBT also tends to use a lot of problem-solving techniques. Taken together, CBT and mindfulness can lead to a better mental state across a variety of conditions. This is why it has been so popular among psychologists. Moreover, in recent years, there has been a call to action to apply techniques that use mindfulness to help with sleep disorders like narcolepsy.

CBT for Narcolepsy

CBT is primarily used to treat the comorbidities associated with narcolepsy. Comorbidity is when two conditions are present at the same time in the same person. Narcolepsy has been associated with anxiety and mood disorders. One study found that the most frequent psychiatric disorders among people with narcolepsy were major depressive disorder and social anxiety disorder. Each of these conditions affected about 20 percent of narcoleptic individuals. Other anxiety disorders were also higher in people with narcolepsy compared to the general public. Post-traumatic stress disorder affected about 11 percent, and nearly 13 percent of people with narcolepsy in the study met the criteria for panic disorder.

In another large project known as the Burden of Narcolepsy Disease (BOND) study, nearly 38 percent of more than 9,000 participants had a mood disorder, and 25 percent of the sample had an anxiety disorder. Both of these studies also demonstrated that women are at a greater risk of having narcolepsy and a psychological disorder than men.

CBT has been shown time and time again to be effective in helping symptoms of anxiety disorders, bipolar disorder, depression, and more. Because people with narcolepsy often have these disorders, CBT may be able to help improve the quality of life of these individuals. In one recent study, 35 adults with narcolepsy or idiopathic hypersomnia went through CBT developed for hypersomnia (CBT-H). This clinical study showed that this new CBT-H program has the potential to reduce symptoms of depression and improve self-efficacy (coping skills) in people with narcolepsy and hypersomnia.

Learn more about how narcolepsy can affect your mental health.

Beyond Treating Comorbidities

Some researchers and physicians think that CBT may even be able to go beyond managing comorbidities. There is very limited research that suggests CBT can help narcolepsy symptoms such as cataplexy. The goal of CBT for narcolepsy (CBT-N) is to manage the behaviors of individuals with narcolepsy. For example, people with narcolepsy should adhere to medication regimens and engage in good night sleep hygiene practices. One review proposes that CBT-N use the following components:

  • Behavioral techniques aimed at changing sleep-disordered behaviors or sleep-related disorder variables that are not compatible (such as sleep satiation)
  • A cognitive component aimed at modifying beliefs, motivations, and emotions that may play an important role in narcolepsy while emphasizing the psychosocial effects of the disorder
  • Education to instruct the person regarding the nature of the narcolepsy, how narcolepsy medications work, and precautions regarding the use of medications

Of the systematic research that has been done, one study used a new method called multicomponent CBT-N. This type of CBT-N includes techniques such as sleep satiation (extending nighttime sleep), nap training, cognitive restructuring (including mindfulness), and problem-solving techniques. In this study, the people who went through multicomponent CBT-N (compared to a control group that did not receive cognitive therapy) had improvements in quality-of-life measures including physical and social function. Improvements were also observed in reports of excessive daytime sleepiness.

Finding Help for Narcolepsy

If you or a loved one has narcolepsy, you are not alone. There is a growing community on MyNarcolepsyTeam where people from all walks of life can discuss narcolepsy, possible treatment options, and more. You may even be able to find out if other people have had success with CBT.

If you want to have a conversation about narcolepsy and find out if CBT has helped anyone in our community, join MyNarcolepsyTeam today.

Allen J. Blaivas, D.O. is certified by the American Board of Internal Medicine in Critical Care Medicine, Pulmonary Disease, and Sleep Medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Brooke Dulka, Ph.D. is a freelance writer at MyHealthTeams. Learn more about her here.

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