Some narcolepsy patients notice a cyclical pattern to their symptoms, noticing a worsening during certain seasons or specific times of the month, according to the Food & Drug Administration (FDA) “Voice of the Patient” report. The cyclical nature particularly relates to their ability to sleep.
The report, published earlier this year, is a summary of accounts from the September 24, 2013 public meeting the FDA hosted as part of its Patient-Focused Drug Development Initiative.
The FDA report states:
One participant commented on annual cycles related to season changes and by show of hands, many participants agreed. As one participant commented, “I feel like my body is controlled by the sun. When the fall comes…my body wants to sleep when it gets dark, and my body wants to awake with the sun.” A few participants described lunar, menstrual, or monthly cycles. A few commented that they cannot explain the cause of their cyclical symptoms.
Participants also identified a variety of factors that they believe can trigger an exacerbation, including stress, anxiety, sleep deprivation, and being hot or dehydrated.
The report also noted that symptoms change over time in other ways. For instance, some participants commented that, even when treated, their symptoms have gotten consistently worse over time or that they have developed new symptoms, such as cataplexy. One participant said during the discussion, “Before, naps would refresh me for short periods of time, but now, even on medication, I feel like an alert zombie.”