Non-pharmacological approaches to the treatment of narcolepsy.
A way of evaluating the part played by non-drug treatments is to study cases of patients who discontinued stimulant medications but still came back for follow-up visits. Out of 40 patients with narcolepsy-cataplexy, three refused medication because their work was compatible with a regimen of naps (follow-up 1 year), and 10 stopped taking drugs when they could adapt nap therapy to a new life-style (follow-up 6.9 +/- 5 years). Three interrelated levels of non-pharmacological treatments of narcolepsy were examined: 1) Behavioral management, which includes: (A) structured sleep schedules: literature shows that a single long afternoon nap proffered greatest performance benefits in reaction time, significantly increased over a no-nap control condition, with no evidence of sleep inertia. The placement of this nap might yield better results if scheduled 1 hour before that of a normal subject. (B) Dietary factors: little is known about the effects of diet in narcoleptics; however, avoiding simple sugars will improve alertness in some patients. 2) Medical and psychiatric aspects of care. 3) Social factors as an interface between the patients and their environment.
Garma
L
L
Unité des Troubles du Sommeil, Hôpital de la Salpêtrière, Paris, France.
Marchand
F
F
D000293:Adolescent; D000328:Adult; D002110:Caffeine; D002940:Circadian Rhythm; D004651:Employment; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006990:Hypnosis; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000628:therapy*; D012064:Relaxation Therapy; D012649:Self Concept; D013315:Stress, Psychological; D014851:Wakefulness
D002110:Caffeine