Understanding the Connection Between POTS and Narcolepsy

Understanding POTS and Narcolepsy

Postural orthostatic tachycardia syndrome (POTS) and narcolepsy are two chronic conditions that can significantly impact a person's quality of life. Though seemingly very different, they share some overlapping symptoms and often co-occur. Getting properly diagnosed and finding effective treatments is key to managing both conditions.

Defining POTS

POTS is a form of dysautonomia, a disorder of the autonomic nervous system which controls involuntary functions like heart rate, blood pressure, digestion, and temperature regulation. In POTS, the autonomic system does not properly regulate blood flow when moving from a reclining to upright position. This causes an abnormally fast heart rate and lightheadedness upon standing.

Common POTS symptoms include:

• Fast heart rate (tachycardia) and palpitations
• Lightheadedness, dizziness, or fainting upon standing
• Exercise intolerance
• Fatigue and weakness
• Cognitive dysfunction like brain fog
• Headache and migraine
• Nausea, abdominal pain, bloating
• Temperature dysregulation with hot and cold extremes
• Insomnia
• Tremors or shakiness

What Is Narcolepsy?

Narcolepsy is a chronic sleep disorder caused by the brain's inability to properly regulate the sleep-wake cycle. People with narcolepsy experience excessive daytime sleepiness, falling asleep at inappropriate times against their will. Narcolepsy has likely autoimmune and genetic components.

There are two main types of narcolepsy:

• Narcolepsy with cataplexy - Sudden loss of muscle tone triggered by emotions like laughter, excitement or anger
• Narcolepsy without cataplexy - Excessive sleepiness without muscle weakness episodes

In addition to daytime sleep attacks, common symptoms include:

• Cataplexy - Sudden loss of muscle control
• Sleep paralysis - Temporary inability to move when waking up or falling asleep
• Hallucinations when falling asleep or waking up
• Fragmented nighttime sleep and insomnia
• Automatic behaviors like continuing to chew after finishing food

The Connection Between POTS and Narcolepsy

Though POTS and narcolepsy affect different body systems, they share an underlying dysfunction of the autonomic system. Researchers have found a higher prevalence of POTS among those with narcolepsy than the general population.

Some contributing factors may include:

• Autoimmune dysfunction attacking autonomic receptors
• Low levels of neurotransmitters like hypocretin that regulate sleep and blood pressure
• Genetic similarities
• Side effects of stimulant medications used to treat both conditions

The most prominent overlapping symptom is fatigue. Both POTS and narcolepsy can cause relentless exhaustion that impairs daily function and quality of life. Brain fog, headache, faintness, gastrointestinal issues, and insomnia also commonly occur.

Getting Properly Diagnosed

Due to the complex nature of dysautonomia disorders, getting an accurate diagnosis can take years for many patients. POTS and narcolepsy symptoms often overlap with other conditions like chronic fatigue syndrome, Lyme disease, epilepsy, and more.

To diagnose POTS, doctors use a tilt table test to measure heart rate and blood pressure while moving from lying to standing. Significant increases in heart rate coupled with symptoms like lightheadedness indicate POTS.

Diagnosing narcolepsy relies heavily on the patient’s reported symptoms, medical history, sleep studies, and multiple sleep latency tests to measure daytime sleepiness. Genetic blood tests can also confirm a diagnosis.

Treatment Options

Though incurable, many effective treatments help manage POTS and narcolepsy to improve patients’ functionality and enjoyment of life.

Common treatments for both conditions include:

• Lifestyle modifications - Diet, exercise, sleep hygiene and stress reduction
• Medications - Stimulants, blood pressure medications, antidepressants
• Compression garments - Help blood return to heart
• Electrolytes and hydration - Essential for dysautonomia regulation

Additional POTS treatments include:

• Increasing salt and water intake - Improves blood volume
• Raising head of bed - Helps prevent nighttime blood pooling
• Strength training - Helps maintain vascular tone

Additional narcolepsy treatments include:

• Scheduled napping - Helps relieve excessive daytime sleepiness
• Sodium oxybate - Consolidates nighttime sleep
• Pitolisant/solriamfetol - Promotes wakefulness

Living Well with POTS and Narcolepsy

Though challenging, living fully with dysautonomia disorders is absolutely possible. Having patience and self-compassion is key. Prioritizing rest when needed and not pushing beyond capacity helps avoid symptom exacerbation. Finding support groups also provides invaluable understanding and advice.

Working closely with knowledgeable doctors and trying various treatments helps determine an effective medical regimen. Making appropriate lifestyle modifications and accommodations further empowers patients. Adjusting expectations, focusing on abilities rather than limitations, and pacing activities helps engender resilience.

With proper treatment and management strategies, most people living with POTS, narcolepsy and overlapping conditions can minimize symptom impacts, graduate school, maintain careers, care for families and more. Continuing research brings hope for more targeted therapies that will further improve quality of life.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.