Cognitive behavioral treatment for narcolepsy: can it complement pharmacotherapy?

Abstract

Sleep medicine in general and psychology in particular have recently developed cognitive behavioral treatment for narcolepsy (CBT-N). Despite a growing interest in this topic, most studies since 2007 have reviewed CBT applications for other sleep disorders. Currently, 6 reviews have been published on narcolepsy, with an expert consensus being reached that CBT represented an important adjunctive treatment for the disease. The current paper reviews the need for CBT applications for narcolepsy by generalizing the application of multicomponent treatments and performing studies that extrapolate the results obtained from multicenter studies. Nineteen studies were found in which the need-for-treatment guidelines identified the use of CBT for narcolepsy. Three additional studies were identified that evaluated the effectiveness of cognitive behavioral measures and multicomponent treatments for which treatment protocols have been proposed.

Current and Future Treatment Options for Narcolepsy: A Review

“…Although the neurological origin of narcolepsy warrants pharmacological treatment as the primary approach, adjunctive psychotherapy has also demonstrated beneficial effects on successful management of symptoms 34 , 35 . Specifically, cognitive behavioral therapy for narcolepsy (CBT-N) has increasingly been identified as an important supplement for treatment, and many features of narcolepsy (e.g., depression and hypersomnia) are already regularly treated with cognitive behavioral strategies.…”

“…Specifically, cognitive behavioral therapy for narcolepsy (CBT-N) has increasingly been identified as an important supplement for treatment, and many features of narcolepsy (e.g., depression and hypersomnia) are already regularly treated with cognitive behavioral strategies. CBT-N focuses on managing behaviors of patients with narcolepsy, such as adhering to medication regimens and engaging in good nocturnal sleep hygiene practices 35 .…”

“…Based on their review of the literature, Marín Agudelo et al summarized the following as effective cognitive behavioral techniques for the management of narcolepsy symptoms: (1a) sleep satiation and (1b) scheduled naps to reduce daytime sleep attacks; (2a) systematic desensitization and (2b) stimulus control to lessen cataplexy episodes; (3) imagery rehearsal therapy to reduce the frequency of and cope with hypnagogic hallucinations; (4) hypnosis to decrease the severity of sleep paralysis; (5) cognitive therapy to reduce adverse effects stemming from dysfunctional cognitions; (6) muscle relaxation to manage anxiety that can worsen narcolepsy symptoms; and (7) diet schedule that optimizes alertness and functioning throughout the day and the quality of nighttime sleep 35 .…”

Sleep and Orofacial Pain: Physiological Interactions and Clinical Management

“…Cognitive behavioral therapy is also available for other sleep disturbances such as sleep apnea, narcolepsy, sleep-wake circadian mismatch, and several pediatric disorders. Therefore, it could be used in several domains [78][79][80].…”

Narcolepsy in Children and Adults: A Guide to Improved Recognition, Diagnosis and Management

“…Regular sleep-wake schedule [36] Cognitive Behavioral Therapy Systematic application of techniques needed to evaluate and improve behavior [37] Scheduled napping Nap that is scheduled during individuals typical height of sleep inertia [38] Strategic napping Planned nap of specific duration to promote performance and alertness [39]…”