Best known as a sleep disorder, narcolepsy may also impact heart health

Many of us have trouble getting enough sleep, and that’s especially true for people with narcolepsy, a rare disorder that can cause symptoms such as:

• Extreme daytime drowsiness
• Sudden, uncontrollable muscle weakness
• Sleep paralysis
• Sleep attacks that can strike at any time 

What is narcolepsy?

Affecting up to 200,000 Americans, the relatively rare condition typically begins in people between the ages of 10 and 30. Those with a family history of narcolepsy are 20 to 40 times likelier to be diagnosed with it.

While most people enter a deep, dream-filled state called REM sleep about 90 minutes after drifting off, people with narcolepsy may enter REM within minutes of dozing off or even while they are still awake.

Untreated narcolepsy can negatively affect many aspects of life, from work to socializing, even driving. Adding to such concerns, it’s associated with high blood pressure, high cholesterol and heart disease.

In fact, a large-scale retrospective study found the risk of stroke, heart attack and heart failure were all significantly higher in people with narcolepsy, who also had an increased number of heart bypass and angioplasty procedures.

How does narcolepsy affect the heart?

More research is needed to better understand the association between narcolepsy and heart health, but a number of factors may be at play.

For most people, blood pressure lowers naturally during sleep, a phenomenon called nocturnal dipping. This is regulated by a protein call hypocretin, which is often deficient in people with narcolepsy. Research suggests an absence or reduction in this nocturnal dipping may increase risk for cardiovascular disease.

Moreover, people with narcolepsy often also have conditions such as diabetes, depression and obesity, which are independently associated with heart disease.

Finally, absent of any other risk factors, not getting enough sleep at night and feeling too tired during the day may increase the risk of heart disease as well.

Indeed, studies show that good sleep patterns are important for cardiovascular health.

Medication may also play a role

Some medications prescribed to keep people awake also tend to increase heart rate and blood pressure.

When taken at its recommended dosage, for example, one commonly prescribed medication for narcolepsy includes up to 1640 milligrams of sodium.

That’s a big chunk of the American Heart Association’s maximum daily sodium recommendation of 2,300 milligrams, and it surpasses the AHA’s ideal recommendation of 1,500 milligrams.

There’s a reason for those recommendations. Whether eaten as table salt or ingested as an ingredient in medicine, sodium has been shown to increase the risk of high blood pressure and events such as stroke.

Additionally, the antidepressants used to treat cataplexy in people with type 1 narcolepsy may make cardiovascular events more likely.

However, there is hope for patients with narcolepsy who are concerned about their health. The FDA recently approved a lower-sodium medication, so if you have narcolepsy, consult your doctor.

Heart-healthy recommendations for people with narcolepsy

While there is no cure for narcolepsy, patients can minimize their risk for heart problems by following many of the same tips recommended to the general public:

Exercise regularly

The American Heart Association recommends getting at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week, or a combination of both, preferably spread throughout the week. Examples include brisk walking, water aerobics, dancing, gardening and tennis.

Eat a heart-healthy diet

To help control weight, cholesterol and blood pressure, the AHA recommends eating nutritious foods from all the food groups. This includes a rainbow of fruits and vegetables, fiber-filled whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes and non-tropical vegetable oils. Limit or eliminate saturated and trans fats, sodium, red meat and sweets.

Don’t smoke

Filled with more than 5,000 harmful chemicals, cigarettes are responsible for about one-third of deaths from coronary heart disease and associated with the vast majority of lung cancer cases in the U.S. In addition, smokers die, on average, 10 years earlier than non-smokers.  

Know your numbers

Knowing your cholesterol, blood pressure, blood sugar and BMI or body mass index is a crucial weapon in the fight against heart disease, helping you to determine your risk and take protective measures, whether lifestyle-related or medication, to stay heart healthy. Ideal numbers for most people are:

• Blood pressure: 120/80 mm Hg
• Body mass index (BMI): 25 kg/m²
• Fasting blood sugar: 100 mg/dL

Practice good sleep hygiene 

While people with narcolepsy have unique challenges when it comes to sleep, practicing good sleep hygiene can help. This means sticking to a consistent sleep routine, avoiding digital screen time before bedtime and sleeping in a room that’s cool, dark and comfortable.