An unconventional match: psychedelics and narcolepsy blur the boundaries of wakefulness and dreaming. Within the complexity of human experiences, even the most unexpected combinations can lead to great discoveries.
Narcolepsy, the neurological sleep disorder, has long puzzled the curious minds of scientists, but research on psychedelics is still in the beginning phases and has yet to directly address this condition.
So far, the scope of psychedelic research has reached into issues of psychological and mood disorders like bipolar disorder (BD), obsessive compulsive disorder (OCD), and even anger issues.
Individual claims and clinical trials report miraculous and unexpected recoveries from taking mind-altering substances like psilocybin, LSD, and MDMA.
We have already covered how psychedelics could be beneficial for complex physical conditions like Parkinson’s disease. Could these same substances have medicinal benefits for those struggling with narcolepsy as well?
With open and compassionate minds, we will explore current psychedelic research for sleep issues, and we hope this article addresses the interesting questions that lie in wait.
What is Narcolepsy?
Narcolepsy is a neurological sleep disorder characterized by excessive daytime sleepiness and a range of other symptoms, such as sudden sleep attacks, that can significantly impact a person’s daily life and functioning.
According to the Narcolepsy Network in 2015, the disorder affects approximately 1 in 2,000 people, although the exact prevalence may vary.
Symptoms & Comorbidities of Narcolepsy:
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- Cataplexy — a sudden episode of muscle weakness and limpness, resulting in temporary paralysis, often triggered by strong emotions such as laughter, excitement, or anger
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- Excessive daytime sleepiness — daytime drowsiness that is hard to resist
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- Sudden sleep attacks — falling asleep at random, undesirable times of the day
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- Sleep paralysis, disturbances & insomnia
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- Hallucinations
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- Excessive and vivid dreams or nightmares
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- Sleep apnea or restless leg syndrome
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- Depression & mood disorders
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- Automatic behaviors — continuing whatever task was being performed prior to a sudden sleep attack, unaware of the interruption or even of the fact that the task is being performed again
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- Memory issues
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- Slurred speech & task incompetency
Cataplexy specifically is a hallmark symptom of narcolepsy and can affect speech, neck posture, and ability to stand upright during an episode. It also can be dangerous if not managed correctly.
There are two types of narcolepsy: Type 1 narcolepsy is diagnosed for those experiencing cataplexy as a symptom, whereas those with Type 2 do not experience cataplexy as a symptom.
While it isn’t fully understood what causes narcolepsy, the hormone hypocretin, which regulates wakefulness, plays a role, in that those with narcolepsy are believed to have insufficiency of this hormone.
The lack of hypocretin can occur as a result of autoimmune conditions, brain injuries, and genetic predispositions, but it is believed that “the loss of hypocretin-producing neurons in the hypothalamus is the primary cause of type 1 narcolepsy’ (National Institutes of Health, 2023).
Furthermore, certain genetic variations have been associated with an increased susceptibility to narcolepsy. Research suggests that specific genes related to the immune system and neurotransmitter production may play a role.
Lastly, it is hypothesized that an autoimmune process may be involved in the destruction of the cells in the brain that produce hypocretin.
Current Treatments for Narcolepsy
Narcolepsy requires ongoing management to alleviate its symptoms and improve the quality of life for individuals affected by this condition.
Treatment for narcolepsy typically involves a multifaceted approach that combines medication, lifestyle adjustments, and support strategies tailored to each person’s needs.
Stimulant medications are commonly prescribed to address excessive daytime sleepiness. These medications promote wakefulness and help individuals stay alert throughout the day.
Another prescription, sodium oxybate, a central nervous system depressant, is effective in managing both excessive daytime sleepiness and cataplexy.
Furthermore, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) may be prescribed to manage cataplexy, hallucinations, and sleep paralysis.
Aside from the many medication options used, establishing a consistent sleep schedule with regular bedtimes and wake-up times can help regulate sleep patterns and reduce excessive daytime sleepiness.
Short daytime naps, strategically timed to combat sleepiness, can be beneficial. Scheduled, controlled naps can help manage symptoms and increase alertness.
Maintaining good sleep hygiene practices, such as creating a comfortable sleep environment, relaxing before sleep, minimizing noise and light disturbances, and avoiding stimulating activities before bedtime, can improve the quality of nighttime sleep.
Cognitive-behavioral therapy (CBT) and other talk therapies can help individuals with narcolepsy address challenges related to sleep patterns, sleep hygiene, and coping with symptoms in everyday life.
Participating in support groups or connecting with others who share the same condition can provide emotional support, guidance, and a sense of community, especially given that many people with narcolepsy tend to isolate themselves throughout their life.
Increasing awareness and understanding among family, friends, and employers about narcolepsy is necessary to foster a supportive environment and facilitate accommodations if needed for the person.
While the aforementioned treatment methods can help manage narcolepsy symptoms, the exploration of emerging therapies, such as psychedelic therapy, presents an intriguing avenue for potential breakthroughs.
The Current Research on Psychedelics & Narcolepsy
Because of the lack of direct research on the topic, the potential therapeutic uses of psychedelics for those with narcolepsy is relevant in addressing adjacent symptoms of the disorder, such as depression and anxiety.
Mood disorders are common comorbidities, and this is likely due to, firstly, the social and life-altering implications of struggling with narcolepsy, as well as the hormonal and physiological factors which typically cause the condition.
Because psychedelics have already shown therapeutic use in treatment of mental health conditions like depression, this may have clinical relevance for narcoleptic patients struggling with those as comorbidities.
There are, however, available studies on entheogenic use and their effects on the different facets of sleep, so this section will cover such research.
How Psychedelics Affect The Brain
Phenomenologically speaking, the psychedelic state resembles the dream state closely, so let’s cover a little of how the brain changes on psychedelics.
Psychedelics function by interacting with certain neurotransmitters in the brain, the most commonly known being serotonin.
Serotonin receptors in the brain are stimulated by the active constituents in these substances like psilocybin and psilocin via their agonistic action on those receptors.
Another notable way in which psychedelics affect the brain is via the Default Mode Network (DMN) which is believed to be active during rumination, self-reflection, and deep focus.
Activity of the DMN is actually decreased in psychedelic use, which likely plays a role in the subjective feelings of ego death, merging with one’s environment, and limitless consciousness.
How Psychedelics Affect Sleep
To get into the actual research available on sleep, a 2020 study recognized the antidepressant potential of psilocybin and its effects on the sleep cycle, and this could be relevant for those subscribed antidepressants for managing their narcoleptic symptoms.
This has implications not only for managing depression as a comorbidity, but also suggests that, if antidepressants are used directly to treat narcoleptic symptoms, psychedelics could have an alternative antidepressant action.
Furthermore, they recognized “that serotonergic psychedelics including psilocybin via 5-HT2A receptors promote neuroplasticity,” and neuroplasticity is a significant feature of recovery in any neurological condition including narcolepsy.
This same study by Dudysova and colleagues evaluated a wide variety of sleep-related factors in 20 individuals, including sleep quality, sleep duration, sleep latency, and REM activity.
It is significant to note that in narcoleptics, entering REM sleep happens much quicker than in those without the condition, occurring within 15 minutes of falling asleep.
This is likely why those with narcolepsy have vivid and active dreams and experience sleep disturbances, because of the circadian rhythm being severely dysregulated.
In the study, Dudysova and colleagues found “that psilocybin significantly increased REM sleep onset latency and showed a trend toward reduced REM sleep duration on the first night after administration. These results are in line with the effects of SSRI, SNRI, TCA, and MAOI antidepressants.”
This finding echoes the previous point about the potential for an antidepressant alternative, but we will revisit the REM sleep and sleep latency point in a bit.
Another study from 2022 showed that, in mice, “latency from injection to the first continuous NREM sleep episode of at least 1-min duration, was significantly increased after psilocin” and that “similarly, the latency to the initiation of any REM sleep was also increased by psilocin” (Thomas et al.).
Furthermore, the role of serotonin in the function of sleep is yet to be fully understood. Whereas serotonin agonists typically increase wakefulness, it was found in a 2020 study that psilocin actually promoted sleep in zebrafish and mice (Oikonomou et al.).
The issue of sleep latency is particularly interesting, given that, if psychedelics can potentially increase the amount of time it takes for someone to fall asleep, this has obvious benefits for someone with a condition characterized by involuntary sleep attacks.
Delayed REM sleep also has potential relevance for narcolepsy treatment, although the functions have yet to fully be explored.
Overall, narcolepsy and its physiological and neurological faculties are not fully understood yet, so concluding whether psychedelics would be beneficial for the disorder would be premature.
Further research is needed on those who actually have narcolepsy, and even in the meantime, data available on psychedelics and sleep function is in the beginning phases.
So far, available findings in clinical trials are intriguing and may even suggest multiple possible therapeutic uses for those struggling with narcolepsy and its various symptoms and comorbidities.
Here are some questions to consider when evaluating psychedelic sleep trials as limited evidence of therapeutic uses in narcolepsy:
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- Do any psychedelics have contraindications with any prescribed medications for narcolepsy?
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- Would increased sleep latency help narcolepsy patients experience fewer unpleasant sleep symptoms such as nightmares and sleep paralysis?
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- Would increased sleep latency improve the sleep cycles of a narcoleptic by increasing the time needed to enter REM and NREM sleep?
Beyond those questions, more research is needed to address:
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- Whether or not psilocybin mushrooms and other psychoactive substances increase or decrease cataplexy and if they are safe for those with cataplexy
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- How psychoactive substances interact with the associated symptom of hallucination and whether these substances worsen or indirectly mitigate that symptom
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- Whether psychedelics are generally safe or beneficial for someone with narcolepsy
Talk to a Psychedelic Professional
Overall, psychedelic therapy and therapeutic use of psychedelics may have benefits for narcolepsy, but until further studies are conducted, any conclusion is uncertain.
If you intend to explore mind-altering substances therapeutically, we encourage you to find professional support to ensure utmost safety during the experience.
We at Psychedelic Passage connect clients seeking safe and transformative intentional psychedelic experiences with a network of pre-vetted professional guides who specialize in optimizing safety and efficacy of the psychedelic experience.
Not to worry, we provide expert health screenings prior to any psychedelic experience, and we even wrote an article to help prepare you prior to your consultation.
Their focus is on harm reduction, providing support from the preparation stage all the way to the integration phase, and holding supportive space for the psychedelic experience itself.
Book a consultation with one of our concierges today to get connected with our extensive network of guides located all over the United States.
Lastly, check out our resources page for more articles and information on the vast world of psychedelic research. We hope this article both informs and helps inspire additional awareness and research around the topic of narcolepsy and psychedelic use.
Frequently Asked Questions About Psychedelics and Heart Health
Q: Are there any known interactions between narcolepsy medications and psychedelics?
The interactions between narcolepsy medications and psychedelics are not well understood. Certain medications used to manage narcolepsy symptoms, such as sodium oxybate or stimulants, may have potential interactions or contraindications with psychedelics.
It is vital to discuss the specifics of one’s medication regimen with a healthcare provider before altering your regimen, especially when taking a psychedelic substance which could potentially have contraindications.
Q: Can psychedelic substances worsen narcolepsy symptoms or trigger cataplexy?
The effects of psychedelics on narcolepsy symptoms are not yet fully understood. However, some psychedelic substances may potentially affect sleep patterns and trigger emotional responses that could impact cataplexy.
Because intense emotional states may trigger cataplexy, the individual variability of narcolepsy symptoms makes it essential to approach psychedelic substances with caution and under the guidance of a healthcare professional.
Q: Can psychedelic therapy address narcolepsy symptoms or improve sleep quality?
The potential benefits of psychedelic therapy for narcolepsy symptoms and sleep quality remain largely unexplored. Current research primarily focuses on mental health disorders and the effects of psychedelics on general sleep.
While some individuals may report subjective improvements, more robust scientific investigations are needed to assess the efficacy of psychedelic therapy specifically for narcolepsy.
