Narcolepsy is a neurological condition that affects your sleep-wake cycles. The condition is relatively rare, with estimates showing it affecting between 135,000 and 200,000 people in the United States.

Narcolepsy’s causes, triggers, and symptoms aren’t well defined or understood. It can sometimes take a decade to get an official diagnosis of the condition. Even after you get a diagnosis, finding a treatment that works to manage your symptoms can be a frustrating process of trial and error.

Many of the neurological drugs prescribed to treat narcolepsy have powerful side effects. For some people, these side effects are worse than narcolepsy symptoms themselves.

Alternative treatments linked to lifestyle and dietary choices have therefore become popular in the narcolepsy community. One alternative treatment that people with narcolepsy consider is the ketogenic diet, often known as keto.

A keto diet isn’t a substitute for a treatment plan made with a doctor. But there may be a reason to believe that keto diet can help some people manage their narcolepsy symptoms. Here’s a look at what we know about keto and narcolepsy.

First, let’s be clear: There are no studies currently available that prove a ketogenic diet can manage symptoms of narcolepsy on its own.

Although there are many anecdotal accounts online of a keto diet working for some people with narcolepsy, there seem to be just as many anecdotes of keto not helping at all or having an unclear impact.

However, there’s one older study from 2004 that looked into the effects of different diets on narcolepsy. Researchers did find that those with narcolepsy experienced small improvements in their daytime fatigue levels while on a low carbohydrate keto diet.

This evidence is extremely limited, but it does suggest that by inducing relative hypoglycemia, or low blood sugar, the keto diet can increase the activation of orexin-containing neurons and make you less sleepy during the day.

There’s also some research, though limited, about how a keto diet can help people treat other neurological conditions.

A 2021 systemic review of the medical literature analyzed 63 studies of keto’s effects on the cognitive function of people with neurological conditions such as Parkinson’s, glucose transporter type 1 deficiency syndrome, and Alzheimer’s.

This review concluded that keto did appear to be effective, though the subject deserves more rigorous study.

Researchers behind that systemic review note that perhaps putting your body into ketosis can reduce oxidative stress and neuroinflammation.

They also point out how microbes in your gut actually influence your cognitive abilities and neurological function (what’s known as the gut-brain axis), emphasizing the importance of nutrition for people with neurological conditions.

Data going back to 2003 shows that people with narcolepsy are more likely to have obesity than people who don’t. Some people believe that the keto diet could work for narcolepsy by reducing blood sugar spikes from glucose and by reducing your overall weight.

How keto works

The ketogenic diet is a very low carb, fat dense diet. It works by replacing carbohydrates in your diet with fats to put your body into what’s called a “ketogenic” state, also called “ketosis.” Ketosis is a natural process that happens when your body uses its own stored fat for fuel.

When you’re on a keto diet, carbs will be limited to less than 50 grams per day, and fat will generally make up between 60% and 90% of your calorie intake.

Protein intake should be kept moderate, typically less than 20% of total calorie intake.

Eggs, high fat meats, poultry, fish, full fat dairy, nut butters, oils, and avocados are staples of meals and snacks when you’re on keto.

Keto can be used for weight loss, but it has other potential health benefits too.

When your body reaches a state of ketosis, it’s no longer using glucose from carbs as its primary energy source. Instead, your body is using ketone bodies — fatty acids your body has converted into usable energy.

Ketones can also cross the blood-brain barrier and power your brain. Some people say that because of this, going into ketosis regularly gives them tremendous clarity and productivity and also makes them more alert.

The keto diet has shown potential benefits in treating:

The official guidelines for treating narcolepsy don’t currently include a keto diet. Other treatments may include traditional and more alternative methods.

Traditional

Treatment for narcolepsy may involve using a strategic sleep schedule that includes short naps spread throughout your day. Medications traditionally prescribed to treat narcolepsy include:

If you experience narcolepsy with cataplexy, you may also be prescribed a tricyclic antidepressant, a selective serotonin reuptake inhibitor (SSRI), or sodium oxybate (Xyrem).

Alternative

Lifestyle remedies for narcolepsy may include changes to your diet other than keto. Alternative strategies for treating narcolepsy include:

  • avoiding alcohol consumption
  • avoiding large, calorie dense meals, especially before bedtime
  • getting regular exercise
  • nutritional supplements, such as vitamin B12
  • calcium, potassium, sodium oxybates, and magnesium (Xywav)

The keto diet is one tool that some people are using to treat narcolepsy. Anecdotally, there are people who say it works, but there are also people who say it didn’t help them.

Conclusive evidence supporting keto as a narcolepsy treatment isn’t currently available, but some older studies do support it.

Narcolepsy is a rare disorder, and while there’s no cure, there are medications to help manage symptoms of cataplexy and drowsiness. There are also a host of alternative therapies, some of which may help you.