If you live with narcolepsy, you are more likely to be overweight. This may be because narcolepsy can lead to an urge to binge eat or use food to regulate wakefulness. Living with narcolepsy can also make it harder to lose weight due to daytime fatigue which, unsurprisingly, can make exercise (or simply being active) less appealing.
Narcolepsy is associated with a reduction (or loss) of hypocretin (also known as orexin). This is a chemical in the brain responsible for keeping us awake. In 2007, a study published in the journal Sleep investigated whether physical activity influenced sleep/wake behavior and whether hypocretin deficiency reduced the wake-promoting effects of exercise.
Researchers disrupted hypocretin levels in mice to mimic narcolepsy (earlier studies have found that such “orexin knockout” mice have strikingly similar characteristics to human narcolepsy patients).
The study found that mice with disrupted hypocretin levels similar to those found in human narcolepsy patients ran 42 percent less often than otherwise healthy mice. However, exercise was found to increase the total amount of wakefulness in both sets of mice.
This suggests that a severe reduction (or absence) of hypocretin does appear to encourage less exercise (probably due to sleepiness and/or reduced motivation) but it may help promote wakefulness.
Why is exercise helpful for narcolepsy?
Narcolepsy Network, a nonprofit national patient support organization, recommends exercise because it can help develop strength and endurance, and improve metabolism — these benefits can reduce sleepiness and increase sleep quality. They suggest exercising when you know you’ll be at your sleepiest (setting a reminder alarm can be helpful), but emphasize that exercise should not be torture and it should not hurt!
Robert Herbst is a personal trainer, wellness coach, and powerlifting champion. In an email interview, Herbst told HealthCentral that exercise can help minimize the effects of narcolepsy because it stimulates neural connections and causes the brain to make dopamine and serotonin. This could, in turn, help reduce the impact of narcolepsy.
The best type of exercise for narcolepsy
Herbst recommends exercises that are likely to cause the production of dopamine, such as running or other cardiovascular activities. He also recommended upper-body exercises, such as curls, lat pulldowns, bench press, and chest fly exercises. Herbst said that heavy movements, such as squats or deadlifts, can tax the central nervous system and are not, therefore, recommended.
The Narcolepsy Network suggests that any type of exercise can be beneficial. Simply making the effort to be active can help promote wakefulness and reduce daytime sleepiness. With that being said, if you experience narcolepsy with cataplexy (the sudden loss of muscle tone usually triggered by strong emotion), this needs to be considered when planning a workout routine.
Since cataplexy can be unpredictable and can be triggered by exercise, you may want to start out with lighter exercise, such as yoga or taking short walks. The National Institute of Neurological Disorders and Stroke (NINDS) does not suggest any specific form of exercise for individuals with narcolepsy. Instead, NINDS simply recommends exercising for 20 minutes every day at least four or five hours before bedtime.
It’s a good idea to discuss any potential exercise routine with your doctor first if you have not exercised for a long period of time, or have any cataplexy-related safety concerns. Studies suggest that exercise can increase daytime alertness and reduce the risk of obesity, but it’s important to seek medical advice before making any significant changes to your lifestyle.