Finding out you’re pregnant when you have narcolepsy can raise a lot of questions. You might wonder if any medications you’re taking are still safe, how your symptoms might change, or whether you’ll be able to safely care for a newborn. You’re not alone — many people living with narcolepsy share these concerns.

Narcolepsy is a rare condition, affecting about 1 in 2,000 people. That rarity can make it feel isolating — especially during pregnancy. The good news is that many people with narcolepsy have healthy pregnancies and babies. But because there are no official treatment guidelines specifically for narcolepsy during pregnancy, it’s important to plan ahead and talk with your doctor early. Partnering with your healthcare team can help you create a care plan that supports both your health and your baby’s development.

This article breaks down what’s known about managing narcolepsy before, during, and after pregnancy, using the best available research and expert advice.

Talking to Your Doctor About Family Planning

If you have narcolepsy and are thinking about becoming pregnant, it’s a good idea to talk with your doctor ahead of time. Even if your doctor doesn’t bring it up, you can take the lead and start the conversation. Some medications used to manage narcolepsy can lower the effectiveness of hormonal birth control, so it’s important to make a plan together.

Your doctor can explain the risks and benefits of your current narcolepsy treatment plan and discuss safer alternatives if needed. Having a family-planning conversation early also gives you time to gradually adjust your treatment, instead of stopping everything suddenly once you find out you're pregnant.

Narcolepsy Symptoms

Narcolepsy disrupts the body’s natural sleep-wake cycle. The main symptom is excessive daytime sleepiness — feeling extremely tired during the day, no matter how much you slept at night. Other symptoms of narcolepsy can include:

• Cataplexy — Sudden loss of muscle control, often triggered by strong emotions like laughter or surprise
• Sleep paralysis — A brief inability to move or speak just before falling asleep or upon waking
• Vivid dreams or hallucinations — Dream-like experiences that can happen as you’re falling asleep

These symptoms can make everyday life more difficult and may also affect your pregnancy and ability to care for a newborn. Some people living with narcolepsy also have trouble with memory, focus, and staying alert for long periods — all of which can make the demands of early parenting even more challenging.

How Narcolepsy May Affect Pregnancy and Childbirth

Pregnancy affects sleep for most people, and for those living with narcolepsy, these changes can sometimes make symptoms more noticeable or harder to manage. Researchers are still learning exactly how pregnancy impacts narcolepsy, but there are a few things to keep in mind. You may experience more fatigue, changes in sleep quality, or shifts in how often symptoms like cataplexy occur.

Cesarean Sections and Birth Complications

Some people worry that cataplexy might occur during labor. However, in a global survey of 34 narcolepsy specialists, most reported that people with narcolepsy had vaginal deliveries without complications. In rare cases, cataplexy interfered with delivery, but if a cesarean section (C-section) was needed, there appeared to be no increased risk from anesthesia or surgery.

One observational study from the European Narcolepsy Network found that people with narcolepsy — particularly those with cataplexy — were more likely to deliver via C-section compared to those without cataplexy. Although cataplexy during labor was reported in only a few cases, the majority of deliveries were uncomplicated.

Another smaller case-control study comparing 25 people with narcolepsy and cataplexy to a control group found no significant differences in complications during or after delivery. Both groups had similar outcomes during childbirth and the postpartum period.

Gestational Diabetes

Some data suggest a higher risk of gestational diabetes in people with narcolepsy. Gestational diabetes is a type of diabetes that first appears during pregnancy. It may increase the chances of having a C-section and also raise the risk of hypertension (high blood pressure) during pregnancy and type 2 diabetes later in life.

Caring for a Newborn When You Have Narcolepsy

Narcolepsy symptoms like excessive daytime sleepiness and cataplexy can make it harder to care for a newborn. In a European study, more than half of participants with narcolepsy symptoms during pregnancy said those symptoms made it difficult to care for their baby. The most common concerns were falling asleep during feedings and struggling with alertness while holding the baby.

Even people who didn’t have symptoms during pregnancy sometimes reported excessive sleepiness after giving birth, which is also common among people without narcolepsy. This shows how postpartum fatigue and sleep challenges can be especially intense for people living with narcolepsy. Getting extra support after delivery can make a big difference.

Narcolepsy Medication Exposure

One of the biggest questions about narcolepsy and pregnancy is how medications might affect the pregnancy or the baby. People with narcolepsy may be prescribed different types of medications, including:

• Stimulants — Help reduce daytime sleepiness
• Sodium oxybate medications — Used for excessive daytime sleepiness and cataplexy
• Histamine 3 receptor antagonists/inverse agonists — Help improve wakefulness
• Antidepressants — Sometimes used off-label to reduce cataplexy symptoms

It’s important to know that research on pregnancy safety varies widely between medications. Each drug comes with its own guidance for use during pregnancy and breastfeeding.

Modafinil and Pregnancy Risks

The stimulant modafinil has been in use since the late 1990s, so we have more pregnancy data for this medication than for newer options. One study using Danish health records found a higher rate of major birth defects among babies exposed to modafinil in the first trimester.

However, a later study in Sweden and Norway that included more pregnancies did not find the same risk. These mixed results show why more research is needed — and why health experts recommend avoiding modafinil during pregnancy unless absolutely necessary.

Antidepressants for Cataplexy During Pregnancy

Some antidepressants used to treat cataplexy are considered relatively safe during pregnancy, though they should be discussed with your healthcare provider.

You and your doctor can work together to weigh the pros and cons of continuing, adjusting, or stopping medication. This is especially important during the first trimester and when planning to breastfeed.

Managing Pregnancy and Narcolepsy

If you stop taking narcolepsy medications during pregnancy, certain lifestyle habits may help you manage your symptoms:

• Follow a consistent sleep schedule.
• Take short, planned naps.
• Avoid caffeine later in the day.
• Get gentle, regular exercise.
• Create a calming bedtime routine.

Keeping a symptom diary and checking in regularly with your healthcare team can also make a big difference. You may want to talk with your doctor about doing a sleep study before or early in pregnancy, especially if it has been a few years since your last one. This can help your care team better understand your current needs and adjust your treatment plan to support both your well-being and your baby’s development.

Involving a neurologist, sleep specialist, and OB-GYN can help ensure coordinated care throughout pregnancy and after your baby is born.

Looking Ahead With Confidence

Narcolepsy may add some complexity to pregnancy, but it doesn’t have to prevent you from having a healthy pregnancy and baby. Planning ahead, understanding your treatment options, and building a strong support system can help you feel more in control.

Talk With Others Who Understand

On MyNarcolepsyTeam, more than 11,000 members come together to ask questions, give advice, and share their stories with others who understand life with narcolepsy.

Have you experienced narcolepsy and pregnancy? Share your experience in the comments below, or start a conversation by posting on your Activities page.