Although little studied, the attitudes of narcolepsy patients towards nicotine raise several issues. Whether patients view nicotine as a useful self-management technique for EDS is unclear. Given that excessive daytime sleepiness (EDS) is the cardinal symptom of narcolepsy, patients who smoke theoretically are at higher risk of injury and property damage.
Participants at the 2007 Narcolepsy Network meeting were surveyed regarding nicotine using a 25-item questionnaire developed by the authors. Seventeen anonymous responses were received, of which eight were from current or past smokers, allowing an exploration of the respondents' perceptions and experiences. No respondents used smokeless tobacco products.
Nicotine was perceived to decrease EDS by all smokers. One respondent reported that nicotine also decreased cataplexy. One-third had fallen asleep at least once while smoking, with many others describing coming very close. Smoking materials had caused fires or burns for two respondents leading to injuries, damaged clothing/furniture/carpet, and total loss of a car. Nicotine cessation was viewed as challenging because of increased EDS by seven respondents.
These preliminary data indicate the need for more in-depth investigation into the risks of smoking for patients with narcolepsy. Nicotine cessation efforts for patients with narcolepsy could be more effective if the perception that nicotine decreases EDS is factored into treatment.
DISCLOSURE STATEMENT
The authors have indicated no conflicts of interest.