If you’re living with narcolepsy, you’ve likely heard of hypocretin (also known as orexin) — a chemical in the brain responsible for keeping us awake. Research suggests that low (or undetectable) hypocretin levels are very common among individuals with narcolepsy.
What does hypocretin have to do with our diet?
The activity of hypocretin/orexin neurons is influenced by a number of hormones, neurotransmitters, and nutrients. Therefore, it makes sense that our diet has an important role to play in managing narcolepsy symptoms.
As well as controlling wakefulness, hypocretin is also responsible for the regulation of our appetite. For this reason, it is thought that untreated narcolepsy may be associated with obesity.
Eating well and maintaining a healthy weight could play an important role when it comes to treating narcolepsy and reducing cataplexy (the sudden loss of muscle control when laughing or during times of strong emotions).
Remember that narcolepsy is associated with low (or undetectable) levels of hypocretin. Therefore, focusing on a diet that might help to increase hypocretin could be a good strategy.
Dietary tips when living with narcolepsy
High levels of glucose have been found to inhibit orexin neurons, so reducing your consumption of sugar and other simple carbohydrates (like those often found in processed and grain-based foods) may be beneficial. Glucose consumption is also associated with more erratic changes in energy levels during the day — so if you are getting most of your calories from glucose, drops in energy levels during the day may trigger narcolepsy symptoms.
Since lactate regulates the orexin system and higher levels of lactate can stop glucose from blocking orexin neurons, eating more lactate might be beneficial. Lactate is generally found in fermented foods and drinks such as kombucha, kimchi, natural yogurt, and sauerkraut.
Introducing the ketogenic diet
The ketogenic diet is a very low-carb diet that encourages the consumption of fat along with moderate intake of protein. Due to the low intake of carbohydrates, the body resorts to burning fat for energy.
Generally speaking, those who follow a ketogenic diet tend to avoid starchy fruits and vegetables (such as bananas and potatoes), grains (such as pasta, cereal, and bread), sugar, and sugar-sweetened foods.
A small study published in 2004 found that patients with narcolepsy who consumed a low-carbohydrate, ketogenic diet for eight weeks experienced lower levels of daytime sleepiness and fewer narcolepsy symptoms compared to those who consumed a control diet.
A ketogenic diet may be beneficial for those with narcolepsy by helping the body become more efficient at turning food into energy (also known as enhancing mitochondrial function).
Additional diet tips
Eating smaller, more frequent meals paced throughout the day rather than sticking to three main meals may help alleviate drowsiness.
Muscle weakness is a symptom of low levels of magnesium and calcium, so eating foods higher in these minerals may be beneficial for those with narcolepsy and cataplexy. Raw nuts and seeds contain particularly high levels of
magnesium and calcium.
Losing weight may help alleviate narcolepsy symptoms. This might be because losing weight lowers leptin levels — and leptin has been found to hinder orexin.
Chronic inflammation has been linked to narcolepsy and lower levels of orexin. Since inflammation is a possible symptom of food sensitivity, a food sensitivity test or a medically supervised elimination diet may be helpful.
Finally, avoiding alcohol and large meals before bed may help reduce narcolepsy symptoms by improving nighttime sleep quality.