Oct 17 2025
Narcolepsy: Seasons of Sleep

Written by Tasha Hill, RN

There’s something quietly transcendent about the arrival of autumn. The breeze carries just enough bite to make a hoodie feel like home. Trees stand in brilliant regalia—amber, crimson, gold and ochre. Winding roads beckon, leading through mountains dressed in their finest robes. And then there’s Halloween. At my house, it’s not just a day—it’s a season. A celebration of playful shadows and sparkle, where mystery waltzes with mischief. Lights glow like enchanted lanterns, the line between fantasy and memory blurs and laughter echoes through the crisp night air. Autumn doesn’t just arrive. It envelops. It enchants. It reminds us that change can be beautiful, and that even in the cooling of the year, there is warmth to be found.

But alas, here I am—a soul wide awake in wonder, trapped in a body that treads the edge of sleep. Narcolepsy, my ever-present passenger, threatens to pull me under when the world is most alive. It demands that I choose between beauty and energy conservation, between the scenic drive and the power nap—forever caught between awe and exhaustion.

Living with Narcolepsy means adapting to changes in how the body regulates sleep and wakefulness. For many of us, those changes occur randomly and some just seem to hit at different times throughout the year. Symptoms shift with the seasons, and while this pattern is often overlooked in clinical conversations, it is a real and measurable part of life with Narcolepsy.

As someone with personal experience, I’ve seen how the disorder is shaped not only by neurobiology but also by environment. Seasonal changes bring distinct challenges that affect sleepiness, nighttime sleep and overall quality of life.

When Seasons Shift, So Does Sleepiness

It turns out that the seasons may quietly shape the way Narcolepsy shows up in our daily lives. A 2025 study published on PubMed examined how seasonal changes affect people living with Narcolepsy Type 1 (NT1), Narcolepsy Type 2 (NT2) and Idiopathic Hypersomnia (IH). Researchers tracked patients throughout all four seasons—autumn, winter, spring and summer—while keeping their medical treatments consistent.

Their findings revealed something fascinating: people with Narcolepsy, regardless of type, experienced the highest levels of daytime sleepiness in summer. Interestingly, the study found no seasonal change in cataplexy frequency among those with NT1. This suggests that while the body’s alertness may ebb and flow with the seasons, cataplexy remains relatively steady.

The researchers don’t yet know why this happens. Even when treatment plans remain the same, many individuals with Narcolepsy notice an increased struggle to stay awake and alert during hot months.

Several factors may contribute to this pattern:

• Heat stress: High temperatures and humidity can disrupt nighttime rest and worsen daytime fatigue.
• Extended daylight: Longer days can push back bedtimes and reduce circadian stability.
• Lifestyle disruption: Vacations, late evenings and changes to daily structure interfere with the routines that people with Narcolepsy rely on to manage symptoms.

Whatever the cause, the results highlight an important truth for those living with Narcolepsy: even the rhythm of the year itself can influence how our condition feels from day to day.

In practice, this can mean more frequent microsleeps, stronger pressure to nap or higher scores on tools like the Epworth Sleepiness Scale. Recognizing this seasonal shift allows for proactive strategies — such as strict sleep scheduling, cooling the sleep environment and optimizing nap timing — to better manage summer’s impact.

The Role of Temperature in Narcolepsy

Temperature itself may also play a direct role in symptom regulation. A study published in Frontiers in Neurology investigated how mild variations in body and skin temperature affect wakefulness in NT1. The research measured core body temperature and distal skin temperature (hands and feet) to assess how these interact with sleep–wake regulation.

The study found that even small temperature changes within normal limits influenced the ability to maintain alertness. Warming the core body temperature helped sustain vigilance and slowed the onset of fatigue, while cooling the hands and feet extended wakefulness by approximately 24 percent. Conversely, warming the extremities made it easier to fall asleep. These results suggest that thermoregulatory mechanisms—specifically the balance between core and distal skin temperature—may impact sleep propensity in Narcolepsy. 

Together, these findings suggest that individuals with Narcolepsy may be more sensitive to environmental and physiological changes than the general population. Seasonal weather shifts and subtle alterations in body temperature can both affect how symptoms manifest day to day.

Understanding these relationships may help clinicians and patients identify external triggers that influence sleepiness or alertness, and support more personalized management strategies. While further research is needed to clarify causation, acknowledging the role of environmental and thermoregulatory factors adds important context to the complex landscape of Narcolepsy care.

Seasonal Patterns and Narcolepsy Onset

Research from the National Institute of Neurological Disorders and Stroke (NINDS) suggests that Narcolepsy may follow a seasonal onset pattern, with new cases more frequently appearing in spring and early summer, often in the months following winter.

This seasonal trend is believed to be connected to immune-related mechanisms. In particular, common winter infections—such as influenza or streptococcal infections—may act as triggers in individuals who are genetically predisposed. The HLA-DQB1*06:02 genetic variant, which is strongly associated with NT1, appears to increase susceptibility when combined with immune activation.

Historical evidence reinforces this link. Following the 2009 H1N1 influenza pandemic, researchers observed a noticeable increase in new cases of Narcolepsy, particularly in populations with the associated genetic markers. This pattern supports the hypothesis that Narcolepsy onset may be precipitated by an autoimmune response initiated after infection.

Taken together, these findings suggest that seasonal and immunological factors play an important role in the timing of Narcolepsy onset. While the condition itself is lifelong and not contagious, understanding these environmental and immune triggers may help inform future research into prevention strategies and early detection for at-risk individuals.

Navigating the Season

Autumn segues into the holiday season and often brings changes in schedule, travel demands, social events and emotional stress—factors that can all affect symptom stability for people with Narcolepsy. Planning ahead and setting realistic expectations can help reduce fatigue, minimize disruptions to treatment and preserve the enjoyment of the season.

• Plan ahead and prepare for flexibility
• Maintain consistent sleep routines
• Set boundaries and prioritize energy
• Communicate your needs with others
• Listen to physical cues and pace yourself
• Simplify traditions when possible

Challenges of Winter

Winter presents a different but equally challenging profile, anecdotally speaking, as there is not a great deal of research that discusses the issue in direct relation to Narcolepsy.

The shorter, darker days of winter reduce the primary zeitgeber, which is a rhythmically occurring natural phenomenon which acts as a cue in the regulation of the body’s circadian rhythms. For patients with Narcolepsy, whose sleep-wake cycle is already unstable, this reduced signal can further destabilize their rhythm. Disruptions to routines, such as during holiday breaks, have been shown to delay the sleep phase and worsen symptoms in patients with Circadian Rhythm Sleep Disorders, a finding likely relevant for Narcolepsy patients. 

Narcolepsy and Depression are strongly linked, with many Narcolepsy patients reporting Depression. This comorbidity can lead to worsened sleep and depressive symptoms during the winter, amplifying the effects of Seasonal Affective Disorder (SAD).

Winter months bring higher rates of respiratory infection, which can temporarily worsen sleepiness, fatigue and brain fog in those already living with the disorder. For this reason, some people in the Narcolepsy community may be proactive about vaccination, infection prevention and immune support as part of their symptom management strategy.

These findings are important because they validate the lived experiences of many in the Narcolepsy community who notice seasonal differences but may not always feel understood when bringing them up in medical settings.

Strategies for Seasonal Adaptation

The seasonal nature of Narcolepsy does not mean treatment is failing — it means symptoms are dynamic and responsive to the environment. Recognizing these patterns allows people with Narcolepsy, alongside their clinicians, to anticipate challenges and adapt strategies.

In summer, helpful adaptations may include:

• Blackout curtains and cooling bedding to reduce sleep disruption from heat and light
• Earlier scheduling of cognitively demanding tasks, before peak afternoon drowsiness
• Consistent nap timing to counteract increased sleep pressure

In winter, helpful adaptations may include:

• Morning light therapy to strengthen circadian cues
• Consistent wake times, even on weekends
• Outdoor breaks or physical activity to counteract mood changes
• Layered bedding and temperature control to reduce nighttime awakenings

Tracking seasonal trends in symptoms — whether through sleep diaries, digital logs or scales like the Epworth — can help make these adaptations more targeted and effective.

The Panoramic Picture

Light, temperature, seasonal infections, mood and lifestyle rhythms all interact with the underlying neurobiology of Narcolepsy. These factors may not alter the disease itself, but they certainly influence its expression in daily life. For patients, that means recognizing that seasonal flux can bring unpredictable challenges. For clinicians, it means listening when patients say their symptoms “feel different this time of year” — and treating that feedback as valuable clinical information rather than anecdote.

Narcolepsy doesn’t always present the same in July as it does in January–sometimes not even the same on Friday as it did on Monday. It shifts, responds and sometimes intensifies depending on seasonal context. Acknowledging these changes, both in research and in clinical practice, can empower people with Narcolepsy to anticipate challenges and apply supportive strategies year-round.

This disorder is lifelong, but it is not static. The more we learn, the better equipped we will be to recognize the changes and begin to look for these patterns as patients–and as providers, the more we can support resilience, stability and quality of life for those living with Narcolepsy.

Dealing with the many challenges we face may seem daunting, intimidating and sometimes disheartening. The Narcolepsy life is not for the faint of heart for sure! But take some comfort–there are resources such as support groups, webinars and information available through organizations like Wake Up Narcolepsy. Research, stay informed, advocate, reach out–you are not alone!

Though the seasons may affect our Narcolepsy symptoms, we will adapt with grace, grit and maybe even just a little sprinkling of magic.

References:

1. Cirillo, Flavia, et al. “Variability of excessive daytime sleepiness and cataplexy according to seasonality: A study in central disorders of hypersomnolence.” Journal of Sleep Research, vol. 34, no. 4, Jan. 2025,
2. “How Does Narcolepsy Affect Your Mental Health?” WebMD, WebMD, www.webmd.com/sleep-disorders/narcolepsy-and-mental-health. Accessed 15 Oct. 2025. 
3. “Narcolepsy.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, www.ninds.nih.gov/health-information/disorders/narcolepsy.
4. Van der Heide, Astrid, et al. “Core body and skin temperature in type 1 narcolepsy in daily life; effects of sodium oxybate and prediction of sleep attacks.” Sleep, vol. 39, no. 11, 1 Nov. 2016, pp. 1941–1949,

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