10 Things to Know About Narcolepsy and Exercise
The most common symptom of narcolepsy? Excessive daytime sleepiness. And these so-called “sleep attacks,” along with the other distressing symptoms, can majorly impact your ability to get things done throughout the day. And while it may seem like the last thing you want to do when you’re drowsy, research shows exercise can be beneficial in helping ward off these symptoms and even improve your sleep quality. Keep reading to get tips on how to use exercise and physical activity to your advantage when you’re managing narcolepsy.
Why People With Narcolepsy Tend to Be Less Active
Adults with narcolepsy weigh about 15% to 20% more than average, according to Harvard Health—and while it’s not certain why this is, experts have some theories. For one, narcolepsy ups your risk of depression, which can make you more sedentary, says Alon Y. Avidan, M.D., professor of neurology and director of the UCLA Sleep Disorders Center. And people with cataplexy—which causes sudden loss of muscle control—may isolate themselves due to fear of an attack in public. Plus, when you’re overwhelmingly tired, depressed, or worried, it makes sense that exercise isn’t a priority—but making it one could help your symptoms.
How Exercise Helps You Sleep Better
“Mild to moderate exercise, as long as it’s not too late in the evening, may be beneficial by improving sleep quality,” explains Mark Wu, M.D., a professor of neurology at Johns Hopkins Medicine in Baltimore. One way working out works for sleep? It can decrease arousal levels, helping to reduce the amount time it takes to fall asleep while increasing overall sleep duration. Plus, breaking a sweat can help you stay alert during the day, says the National Sleep Foundation (NSF).
Why Exercise May Improve Narcolepsy-related Depression
Narcolepsy is linked with increased risk of depression, according to the NSF, possibly because of the stressful and often isolating symptoms as well as potential changes in brain chemistry that affect mental health. If you have narcolepsy and you’re also feeling depressed, exercise is even more important—that’s because it can relieve symptoms just as well as antidepressants in some people, according to Harvard Health. Breaking a sweat increases your levels of feel-good endorphins, plus it can take your mind off your worries, say experts from the Mayo Clinic.
Build Up to 20 Minutes of Exercise a Day
Even if you hate exercise, try to get in at least 20 minutes every day—that’s what the National Institutes of Health (NIH) recommend for people with narcolepsy. If you’re brand new to exercise, it’s perfectly OK—not to mention safer—to start slow and simple. Start with a good old-fashioned walk around your neighborhood. As you build up your fitness, you can increase your intensity and/or duration.
Opt for Cardio
Both Drs. Wu and Avidan recommended aerobic exercise—a.k.a. cardio. “This should improve sleep quality and also help burn calories,” Dr. Wu says. In fact, one study in Sleep Medicine found that narcolepsy patients with greater levels of cardiopulmonary fitness (meaning related to the heart and lungs) had lower degrees of sleepiness and less frequent episodes of cataplexy. How to get it? Try one of these: brisk walking, jogging, or running; dancing; biking; swimming; climbing hills or stairs; playing tennis; doing yard work.
Pay Attention to Timing
The ideal time to exercise is the afternoon, says Dr. Avida, although any time before evening that you can fit it in your schedule is fine. “Late afternoon exercise is recommended because when people finish their exercise, there is a semi-steep drop in the core body temperature, which raises levels of melatonin in your bloodstream,” he explains. That melatonin helps you feel more tired as you’re trying to fall asleep later.
But exercise too close to bedtime is a no-go: “Then you’re likely to be more vigilant and hyper-aroused, and the exercise can be more disruptive, so you have the opposite effect,” he says.
Work Physical Activity Into Your Daily Routine
You don’t have to get super intense with your workouts or even invest in a monthly gym membership to help with your narcolepsy symptoms—a daily walk during your lunch break can do the trick, says the National Sleep Foundation. It also doesn’t even have to be an “obvious” workout activity—daily chores can count! For example, gardening for 30 to 45 minutes counts as an adequate amount of moderate-intensity physical activity, according to the NIH. Other great examples include pushing a stroller 1.5 miles in 30 minutes and shoveling snow for 15 minutes.
Make Exercise Social
Because narcolepsy can be an isolating condition, finding a workout buddy can be helpful, says Dr. Avidan. “It may be that individuals who are more socially isolated and less likely to be involved in sports as a leisure activity are individuals who are more likely to be sedentary and sleepy compared with individuals who incorporate cardiovascular fitness into their lifestyle,” he says. Think of it like a protective shield against your narcolepsy—engaging in group exercise can reduce feelings of depression and loneliness while helping you sleep better, too.
Consider Light Exposure
Light exposure impacts sleep disorders like narcolepsy—and you can take this into account when planning your physical activity for the day. Maximizing your light exposure in the morning helps regulate your body’s circadian rhythm and sleep/wake cycle, Dr. Avidan says. This might mean you get out for a brisk walk every morning or plan your workouts outdoors.
And don’t forget—avoiding light exposure after 9 p.m. is also important to protect sleep, he adds. That includes blue light from devices!
Get Active to Improve Your Narcolepsy Symptoms
While physical activity won’t cure your narcolepsy, getting active can make a real difference in your symptoms, from giving you the jolt you need to stay alert during the day to improving sleep quality at night—not to mention improving your mental health! And remember, it’s always a good idea to talk to your doctor before starting a new exercise routine. They can give you handy tips and considerations specific to your symptoms and your personal health.
- Exercise and Sleep: National Sleep Foundation. (n.d.) “How Does Exercise Help Those With Chronic Insomnia?” sleepfoundation.org/articles/how-__does-exercise-help-those-chronic-__insomnia#:~:text=One%20way%20may%20be%20by,arousal%2C%20anxiety%20and%20depressive%20symptoms.
- Exercise and Depression (1): Mayo Clinic. (2017). “Depression and Anxiety: Exercise Eases Symptoms.” mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495
- Exercise and Depression (2): Harvard Health. (2019). "Exercise Is an All-natural Treatment to Fight Depression." health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression
- Aerobic Exercise Examples: National Institutes of Health. (2020). “Four Types of Exercise Can Improve Your Health and Physical Ability.” nia.nih.gov/health/four-types-exercise-can-improve-your-health-and-physical-ability
- Cardiopulmonary Fitness and Narcolepsy Study: Sleep Medicine. (2017). “Cardiovascular fitness in narcolepsy is inversely related to sleepiness and the number of cataplexy episodes.” pubmed.ncbi.nlm.nih.gov/28522101/
- Cataplexy Study: Sleep Medicine. (2011). “The Clinical Features of Cataplexy: A Questionnaire Study in Narcolepsy Patients With and Without hypocretin-1 Deficiency.” pubmed.ncbi.nlm.nih.gov/21145280/
- Diet and Alcohol With Narcolepsy: “The National Sleep Foundation. (2020). Diet, Alcohol, Exercise, and Narcolepsy.” sleepfoundation.org/narcolepsy/treatments/diet-alcohol-exercise-and-narcolepsy
- Narcolepsy Self-Care: Harvard Health. (2018). “Self-Care.” healthysleep.med.harvard.edu/narcolepsy/treating-narcolepsy/self-care
- Narcolepsy Facts: National Institutes of Health. (2020). “Narcolepsy Fact Sheet.” ninds.nih.gov/Disorders/Patient-Caregiver-Education/fact-Sheets/Narcolepsy-Fact-Sheet#3201_1
- Physical Activity Guide: National Institutes of Health. (2020). “Guide to Physical Activity.” nhlbi.nih.gov/health/educational/lose_wt/phy_act.htm