The psychosocial aspects of narcolepsy.

Although referrals for narcolepsy are increasing, physicians continue to confront obstacles in diagnosing and treating this condition. Patients with narcolepsy also face challenges at work, at school, and at home. One of the more disturbing problems is the lack of public awareness of the disorder and its potential therapy. As a result, patients with narcolepsy are often viewed in the school or work setting as being "lazy." In addition, the psychological and sexual side effects of the medications currently available to treat narcolepsy can lead to marital, family, and work-related problems. Irritability, anxiety, and impotence are common. Of particular concern are the risk for a serious automobile accident when the person with narcolepsy remains untreated and the reluctance of narcoleptic patients to seek treatment for fear of losing their driver's license. This article addresses the health system factors that influence the identification and care of patients with narcolepsy and focuses on the psychosocial impact of the disease.