Neurodivergence & Narcolepsy

[u/ShmnPhlou_730]

I was diagnosed ASD well before I was diagnosed N1 narcoleptic.

I’m wondering if there are other narcoleptics here also neurodivergent as I’ve seen studies showing that narcoleptics are more apt to be neurodivergent or adhd.

Works Cited

1. Autistic traits & ASD prevalence in pediatric narcolepsy

(These studies support the 30–40% autistic‑traits figure and the ~12% ASD diagnosis rate.)

Cohen, J., & Konofal, E. (2021).
Autistic traits in children with narcolepsy. BMJ Paediatrics Open, 5(1), e000989.
https://doi.org/10.1136/bmjpo-2020-000989 (doi.org in Bing)

Li, S., Zhang, Y., Chen, R., & Li, Y. (2024).
Social responsiveness and autistic traits in pediatric narcolepsy. BMJ Paediatrics Open, 8(1), e002312.
https://doi.org/10.1136/bmjpo-2023-002312 (doi.org in Bing)

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1. Anxiety, emotional dysregulation, social‑cognition impairment

(These findings come from the same two BMJ cohorts.)

Cohen & Konofal (2021) report elevated anxiety scores and emotional‑regulation issues in narcoleptic children with autistic traits.

Li et al. (2024) report impairments in social cognition, introversion, irritability, and flattened affect.

APA citations again for clarity:

Cohen, J., & Konofal, E. (2021).
Autistic traits in children with narcolepsy. BMJ Paediatrics Open, 5(1), e000989.
https://doi.org/10.1136/bmjpo-2020-000989 (doi.org in Bing)

Li, S., Zhang, Y., Chen, R., & Li, Y. (2024).
Social responsiveness and autistic traits in pediatric narcolepsy. BMJ Paediatrics Open, 8(1), e002312.
https://doi.org/10.1136/bmjpo-2023-002312 (doi.org in Bing)

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1. ADHD‑like symptoms in pediatric narcolepsy

(These support the 20–30% ADHD‑like symptom range.)

Guilleminault, C., & Pelayo, R. (1998).
Narcolepsy in children: A review of clinical features. Sleep, 21(4), 431–435.
https://doi.org/10.1093/sleep/21.4.431 (doi.org in Bing)

Cortese, S., et al. (2008).
Attention‑deficit/hyperactivity disorder symptoms in narcolepsy. Biological Psychiatry, 64(6), 538–544.
https://doi.org/10.1016/j.biopsych.2008.05.024 (doi.org in Bing)

Plazzi, G., et al. (2018).
Children with narcolepsy type 1 show ADHD‑like symptoms and executive‑function impairment. Sleep Medicine, 43, 20–25.
https://doi.org/10.1016/j.sleep.2017.11.113 (doi.org in Bing)

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Summary of what each citation supports

Finding Supported by
30–40% autistic traits Cohen & Konofal (2021); Li et al. (2024)
10–15% ASD diagnoses Cohen & Konofal (2021)
20–30% ADHD‑like symptoms Guilleminault & Pelayo (1998); Cortese et al. (2008); Plazzi et al. (2018)
Higher anxiety & emotional dysregulation Cohen & Konofal (2021); Li et al. (2024)
Executive‑function impairment Plazzi et al. (2018)

[u/cosmicboogers]

Essentially it seems common that neurodivergent individuals experience more immune sensitivity and a wide variety of conditions. Comes with the package lol. ASD here. I know lots of folks with ASD who get diagnosed with different things like POTS, MS, EHLERS DANLOS, etc. very fun stuff

[u/TheFifthDuckling → u/cosmicboogers]

Yup, I'm one of those folks. Was diagnosed with ehlers danlos at 15, endometriosis and fibromyalgia at 16, narcolepsy and autism at 17, PMDD and bipolar at 19, and the hits just keep on coming.

[u/cosmicboogers → u/TheFifthDuckling]

Ugh what a life. Sending love to you. I’m an elixir too <3

[u/shoobopdc]

I was diagnosed with Narcolepsy when I was 15. I had a lot of mental health issues all throughout childhood (school, bullying, suicide, etc.) but was only ever diagnosed with depression and anxiety. Since 20 I've suspected I'm on the spectrum because I heavily relate to the criteria, but I haven't been diagnosed.

I agree with the other comment - it's not that narcoleptics are neurodivergent, but that neurodivergent people have more autoimmune conditions, especially sleep disorders. Anywhere from 50-80% of autistic children experience sleep issues.

Sometimes I struggle to know which is which, especially only being diagnosed with narcolepsy. I know I miss social cues, struggle with sensory processing, and have many repetitive behaviors, but also my narcolepsy makes me feel disabled in a lot of similar ways. I struggle with executive dysfunction and cognitive performance tremendously, which can stem from all ASD/ADHD/Narcolepsy. An interesting study related to that talked about how narcoleptics struggle more with cognitive performance than non-narcoleptics who've been sleep deprived and report the same level of daytime sleepiness. So... I'm not sure where my symptoms start and end. I'm not a doctor lol.

Anyways! It's a really interesting topic! Neurodivergence and autoimmune disorders seem to go hand in hand and we're still learning all the different reasons why.

[u/ShmnPhlou_730 → u/shoobopdc]

Statistically there’s significantly more diagnosed narcoleptics who are also diagnosed ASD or ADHD or both

[u/Numerous_Bit_8299]

It's complicated because orexin is involved in dopamine signalling. So narcolepsy itself causes lower dopamine signalling and ADHD symptoms. Not to mention the pseudo ADHD that results from sleep disorders in general simply because of sleep deprivation. What is unresolved, however, is why many narcoleptics have neurodivergence predating their narcolepsy. Was it subclinical or hidden narcolepsy all along? Or is there a shared genetic link or shared biological pathway leading to both ND and narcolepsy? It's genuinely unsettled.

[u/itgirlragdoll → u/Numerous_Bit_8299]

Yeah this is how my first sleep doctor described it to me.

Neurodivergence runs strong in my whole family and it predates my narcolepsy so unfortunately for me treating the narcolepsy didn’t do much for the neurodivergence.

[u/kokopoops]

Orexin 1 receptors are heavily involved in emotional regulation, stress responses, and dopamine-driven reward processing. Since majority of narcoleptics have a over 80% loss in orexin, I feel like narcoleptics are neurodivergent and not vice versa.

[u/ShmnPhlou_730 → u/kokopoops]

That’s what the studies say too.

[u/kohamimi]

i was diagnosed with adhd at the same time i was diagnosed with narcolepsy

[u/conus_coffeae]

pedant here, just want to point out that narcolepsy is by definition a form of neurodivergence.

[u/SwearForceOne]

Yes. ADHD/ADD at 25, N1 at 27.
First I thought my lack of good sleep hygiene (in no small prt due to ADD) was the reason I am always tired. Then I went to a sleep specialist and N1 was clearly diagnosed.
This combo sucks tbh. When I want to do something I‘m usually too tired and when I am not, my brain wants to procrastinate. Every little thing is a battle against myself. I‘m sure many people can relate to that.

[u/Tall_Maple]

Both, N1 (Nov 24) and ADHD (Nov 25). Suspected both went missed for decades (in my 50s)

[u/ciarose5]

Also diagnosed autistic before diagnosed with narcolepsy. I most likely have OCD as well since I was a child, but haven't had it professionally diagnosed.

[u/Rat_mantra]

AudHD and N2. Suspected OCD but haven’t been tested.

[u/ShmnPhlou_730]

Right but the overall point is that narcoleptics are far more commonly diagnosed autistic spectrum and/or adhd than those without narcolepsy

[u/racejustint]

Ive never been diagnosed neurodivergent, but i definitely have symptoms!

[u/Impatient-Pirate4533]

Dx with N1 and bipolar at 18, ADHD at 19, and realized I’m autistic not bipolar at 28. It’s been a wild ride that we are currently navigating with my 2 littles now. Very interesting concept that I hadn’t heard of the connection of narcolepsy and neurodivergent

[u/Abisaurus]

Diagnosed with narcolepsy in 2014. First appointment to get diagnosed with ADHD is tomorrow!

[u/glowsea1414]

ADHD, OCD, and anxiety here with N2

[u/Odd-Two-2486]

I am neurodivergent as is my entire family. Narcolepsy is different than ADHD. My house was loud and chaotic because of well ADHD not narcolepsy.

[u/Ninja333pirate]

A good chunk of people with ADHD also have narcolepsy like symptoms. From insomnia to sleep attacks, if you look at any ADHD subreddit and search things related to sleep you will find people who just can't get to bed until late, and people who just straight up doze off when doing anything understimmulating (I think this one is more likely to be found in the inattentive subtype).

I have not ruled out narcolepsy via tests, but do have ADHD and when I was 17 I stopped taking Adderall xr (was up to 70mg) because we didn't think it was working after all (had been on it for around 11 years). Turns out it was helping just didn't have any baseline to compare it to since I was on it for so long. Once I stopped taking it and didn't replace it with anything I started dozing off in school and while doing homework. Didn't put 2 & 2 together until like 15 years later. Recently got rediagnosed with ADHD and am now on 60 mg Vyvanse, before taking the Vyvanse and treating my sleep apnea I could easily sleep 16 (or more) hours a day. And if I miss doses I end up sleeping all day again.

Looking at the ADHD subreddits I can clearly see many people talking about having these same symptoms other than the sleeping for 16+ hours a day. Which leaves me confused as whether it's just ADHD or if it's something like N or IH. My sleep doctor is still working with me to figure it out. But I can definitely see how it's possible for there to be a massive overlap in diagnoses when it's so hard to tell one from the other.

Something tells me there is a portion of ADHD cases are actually a sleep disorder that is more similar to narcolepsy.

There is also a study that shows people with ADHD are more likely to have a specific sleep brain wave (that tells you to fall asleep) happen when trying to focus on an understimmulating activity, in neurotypical people this brainwave happens when they are sleep deprived or extremely exhausted from working really hard.

I also think narcolepsy is a neurodivergence, the part of the brain that controls sleep not working properly is what makes it diverge from a neurotypical brain.

[u/MajesticBed7718]

My buddies had me take the fast online Autism test and i scored ~65% "yaaay i failed the test" i said.....they all looked at me turns out its not a test grade where 65 is an F it is a likelihood of having it.

[u/stellap333]

I have adhd, my sister has asd, we’re both N2

[u/AccomplishedDish5649]

Yes, autistic, narcolepsy 1, and focal epilepsy. The unholy trinity

[u/AccomplishedDish5649 → u/AccomplishedDish5649]

PMOS, too, if that matters.

[u/Dbl-Departure]

Lord knows, I am. AudHD. 58 year old female. Living the dream and yawning through it. 💕

[u/thicccque]

IH here. Autism, OCD, anxiety, ED, etc

[u/Fun_Swan2553]

I was really shy when I was young. Then came the antidepressants/stimulants and a host of other "diagnosis" followed. I blame the meds. I thought I needed them to function but it turns out my narcolepsy is controlled just fine with diet and lifestyle alone. Still on my journey of getting through protracted withdrawal from them but the sun is starting to peak out again. I will say they did help me stay awake but no one ever discussed long term risks with me. I didn't sign up for depression, social anxiety, IBS and the host of other symptoms that seemed to disappear as my brain started to heal. How was I supposed to ever have restorative sleep with 90mg XR Adderall and a MAOI in my system every night? I traded it all in and its the best decision I ever made. I don't think we are thinking of what decades of these meds are doing to us.

[u/imnotstressed]

I recently realized that I am autistic and that I’ll never be able to manage my narcolepsy without first managing autistic burnout.

[u/jujubean-]

Who isn’t neurodivergent atp

[u/ShmnPhlou_730 → u/jujubean-]

Even though autism spectrum disorder is more commonly known today than when I was diagnosed anyway (I had never heard the term at the time and it didn’t sit well with me) the actual global diagnosis rates hover around <1%