Most people with narcolepsy can legally drive, but there are risks attached. Due to the variation in people’s symptoms, doctors measure driving safety on a case-by-case basis, not generally.

Narcolepsy is a neurological disorder of sleep-wake control in which elements of sleep intrude into wakefulness. After obstructive sleep apnea, narcolepsy is one of the most common causes of disabling daytime sleepiness.

The hallmark symptom is excessive daytime sleepiness, which may cause a person to fall asleep suddenly, often at inappropriate times. The sleepiness may be so severe that a person rapidly dozes off with little warning. These episodes are known as sleep attacks.

This article looks at driving with narcolepsy, the risks involved, some safety tips, and other risks of narcolepsy. It also looks at some other tips to help manage the condition.

Close up of steering wheel as person is driving with narcolepsy. Share on Pinterest
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Many people with narcolepsy are able to drive, technically and legally. However, the condition raises the risk of impaired driving, and studies consistently show decreased driving performance among people with the condition.

In the United States, most states employ a voluntary procedure for people to determine their medical ability to drive. Some states also allow for family members or professionals to submit concerns to the Department of Motor Vehicles. Most states do not list narcolepsy as a reason to revoke a person’s license, though some do name it as a condition that may affect the ability to drive.

Some people with severe narcolepsy may not be able to drive at all. A doctor may order a maintenance of wakefulness test (MWT) to ascertain how well a person is able to remain awake during activities such as driving.

There are currently no established guidelines for determining how appropriate driving is for a person with narcolepsy. An MWT is the most common evaluation to determine a person’s level of alertness, though experts advise caution in applying MWT as a predictive measure for driving risk.

People with narcolepsy are at higher risk of experiencing sleep-related accidents while driving than the rest of the population. This is due to the excessive daytime sleepiness, the onset of sleep attacks, cataplexy, and sleep paralysis.

The sections below look at each of these risks in more detail.

Sleep attacks

Sleep attacks occur when a person falls asleep suddenly and without warning, often in people with narcolepsy. These episodes can last for seconds or minutes, which makes driving especially dangerous.

Some sources suggest that over half of people with the condition have fallen asleep while driving and that more than 1 in 3 people with the condition have had an accident.


Cataplexy also raises the risk of accidents while driving. Not all people with narcolepsy experience cataplexy.

Cataplexy is emotionally triggered transient muscle weakness. Most episodes are triggered by strong, generally positive emotions, such as laughter, joking, or excitement. Anger or grief can also trigger these episodes in some individuals.

Drowsy driving

Drowsy driving is a major concern for people with narcolepsy, who usually experience excessive daytime sleepiness.

Drowsy driving refers to the combination of driving and sleepiness or fatigue, which can result in a person:

  • having an impaired ability to make good decisions
  • not being able to pay proper attention to the road
  • having slow reaction times when they need to steer or brake suddenly

Sleep paralysis

Sleep paralysis is the temporary inability to move or speak while waking up or falling asleep. Sleep paralysis can be distinguished from cataplexy because sleep paralysis occurs upon awakening or falling asleep, whereas positive emotions trigger cataplexy.

Episodes of sleep paralysis can be frightening because the immobility may be accompanied by visual hallucinations or a sensation of suffocation.

To reduce the risk of accidents while driving with narcolepsy:

  • Avoid driving for longer than 30–60 minutes at a time.
  • Avoid long drives and areas of heavy traffic, such as crowded highways.
  • Pay close attention to one’s level of sleepiness and fatigue.
  • Pull over in a safe place if one becomes sleepy while driving.
  • Avoid driving after consuming a heavy meal or drinking any alcohol.
  • Avoid early morning and late night driving.
  • Take strategic naps before driving.

People with narcolepsy may be at risk of certain dangers that do not usually apply to other people. This is mainly due to suddenly falling asleep or losing muscle tone from an episode of cataplexy.

Other possible risks include:

  • a danger of falling asleep or losing muscle control while operating dangerous tools or machinery
  • a danger of sustaining an injury in the home, such as while cooking, climbing a ladder, or using stairs
  • other sleep disorders, such as sleep apnea and insomnia

To reduce the risks associated with narcolepsy, a person should listen to their body and individual symptoms. Narcolepsy is a spectrum, and it manifests differently in every individual.

Here are some general tips for people with narcolepsy:

  • Seek treatment from a doctor, which may include medications to target either daytime sleepiness, cataplexy, or both.
  • Take strategic naps throughout the day and maintain a consistent sleep schedule.
  • Avoid certain activities that may be dangerous, such as swimming alone or using dangerous tools.
  • Avoid excessive alcohol consumption, especially if taking certain narcolepsy medications, and drinking at inappropriate times.
  • Avoid operating dangerous machinery.
  • Maintain a comfortable sleeping environment to try to get quality sleep.

Daytime sleepiness is a common symptom of narcolepsy. It is also associated with sleep attacks that can come on quickly, which can be dangerous if a person is driving.

People with narcolepsy do not necessarily have to give up their driver’s license. As long as the person takes certain precautions, it is possible to drive with narcolepsy.

However, individuals with narcolepsy should discuss their diagnosis and symptoms with a doctor to find out whether or not it is safe for them to drive.