Depression is more common in people who have narcolepsy than those who do not, but the exact relationship between these two conditions remains unclear.
In some people, doctors initially misdiagnose narcolepsy as a mental health condition, such as depression. And people with narcolepsy are more likely than those without it to have certain other mental health conditions, such as anxiety.
A number of factors may help explain a correlation between depression and narcolepsy, including potential similarities in brain chemistry and the challenges that having narcolepsy can pose.
Future research may clarify whether narcolepsy causes or is a risk factor for depression, and whether similar neurological distinctions can lead to both conditions. Keep reading to learn more.
Mental health conditions, including depression, are more common in people with narcolepsy.
A 2020 meta-analysis of 31 prior studies found that people with narcolepsy have depression or depression symptoms at a rate of 32%. This is almost
Narcolepsy may undermine the quality of life, leading to depression symptoms. However, determining whether having narcolepsy causes or contributes to depression requires further studies.
Some research suggests that similar mechanisms lead to both conditions, such as distinctions in the brain’s structure or chemistry, or genetic combinations that increase the risk of both conditions.
Meanwhile, a 2020 study highlights research suggesting that a hypocretin deficiency may play a role in depression, and this deficiency can be a sign of narcolepsy. Hypocretin is a chemical messenger that helps regulate arousal, appetite, and wakefulness.
Overall, more research is needed to fully understand the factors that link depression and narcolepsy.
Narcolepsy may cause some symptoms in common with depression, including:
- intense sleepiness, or sleeping too much
- being irritable
- seeming distracted or uninterested in activities once enjoyed
- trouble with making decisions
One difference is that in someone with narcolepsy, these symptoms may stem from the intense drowsiness that characterizes the condition.
A person with narcolepsy may also feel frustrated or angry about their symptoms. Or they may express hopelessness about life because of the challenges of living with their condition.
When a person has both depression and narcolepsy, it can be difficult to distinguish the symptoms of one condition from the other. When some symptoms linger after treatment, this can signal that a person has both conditions.
Doctors diagnose depression based on
They may also rule out other medical conditions, which can require testing. For example, symptoms of anemia can mimic those of depression, so the doctor may check the levels of iron in the person’s blood. If the doctor does not suspect another medical condition, they may diagnose depression based solely on its symptoms.
To diagnose narcolepsy, doctors consider symptoms, sleep habits, and some physiological signs. A person must have
- Deficiency of hypocretin: A doctor can diagnose this with a blood test.
- Sleep latency issues: A person must take 15 minutes or less to enter REM sleep, which causes dreams, or 8 minutes or less to fall asleep. A sleep study can determine this.
- Episodes of cataplexy: Cataplexy is loss of muscle coordination and control. It may occur with or without a sleep episode.
If a person has depression and narcolepsy, the doctor may fail to test for narcolepsy and initially miss the diagnosis.
With or without depression, a person with narcolepsy may be more likely than others to have:
- anxiety, including generalized anxiety disorder or phobias
- psychosis, which refers to disconnection from reality, such as in schizophrenia
- REM sleep behavior disorder, which causes unusual behavior during REM sleep, usually during dreaming
- cognitive impairment
According to a 2020 study, some researchers believe that a hypocretin deficiency, a common finding in people with narcolepsy, may cause neuropsychiatric disorders, including depression and attention deficit disorders. However, confirming this requires more research.
Meanwhile, other illnesses may mimic symptoms of both mental health conditions and narcolepsy. For example, a 2018 case report describes a situation in which doctors initially misdiagnosed sleep apnea as narcolepsy and depression.
A person may feel anxious or frustrated about their narcolepsy symptoms. And others may mistake the person’s sleepiness for depression or disinterest.
Narcolepsy may occur with cataplexy, a sudden, temporary loss of voluntary muscle control. If a person has both, they may be
- cataplexy during periods of sudden, intense emotion, such as when laughing
- lucid dreams
- scary or otherwise unpleasant dreams
- impaired emotion processing
These conditions both require treating. Some options include:
Strategies such as taking frequent 15–30 minute naps, may ease some narcolepsy symptoms. It is also important to have a regular, adequate sleep schedule.
Regular sleep may also help with depression. And some people find relief from exercise, a healthy diet, following a schedule, and making time for enjoyable activities.
Therapy, especially cognitive behavioral therapy and interpersonal therapy, can be
Therapy cannot cure narcolepsy, but it may help a person cope with the diagnosis and make beneficial lifestyle changes.
Narcolepsy and depression commonly occur together, and symptoms of one diagnosis may conceal the other.
If treatment for one condition is ineffective, speak with the prescribing healthcare professional. Be sure to describe all the symptoms in detail.
Narcolepsy and depression can be difficult to live with and require ongoing treatment and support. This may involve trying different medications, particularly if one loses effectiveness over time.
Working with a doctor who has experience treating both diagnoses can help.