At first glance, narcolepsy and insomnia seem like total opposites. One is all about excessive sleepiness during the day, and the other is about struggling to fall or stay asleep at night. So the question naturally comes up: Can you actually have both narcolepsy and insomnia at the same time?

The short answer? Yes, it’s totally possible—and it’s a lot more common than you might think. If you’re someone who deals with daytime drowsiness but still finds yourself wide awake at 2 a.m., you’re not alone. People who live with narcolepsy often experience nighttime sleep disruptions, and some may even meet the criteria for clinical insomnia.

Let’s dig into what’s going on here, why this happens, how it’s diagnosed, and most importantly—what you can actually do about it. We’ll break things down in a simple, conversational way, no medical degree required.

Narcolepsy vs. Insomnia: What’s the Difference?

Before we dive into the overlap, let’s get clear on what each condition really means.

Feature	Narcolepsy	Insomnia
Main Symptom	Excessive daytime sleepiness	Trouble falling asleep or staying asleep
Sleep Quality	Sleep is often fragmented	Sleep is typically poor or insufficient
Other Symptoms	Cataplexy, sleep paralysis, hallucinations	Racing thoughts, stress, anxiety at bedtime
Onset	Usually appears in teens or early adulthood	Can develop at any age
Cause	Often linked to loss of hypocretin (a brain chemical)	Varies: stress, mental health, habits, etc.
Treatment	Medication, lifestyle management	Sleep hygiene, therapy, meds if needed

So yeah, they sound pretty different, right? But here’s where things get interesting: people with narcolepsy often experience sleep disruptions that look a lot like insomnia. Just because someone is super sleepy during the day doesn’t mean they sleep like a baby at night.

So… Can You Really Have Both?

The short answer is yes—and it’s not just a theoretical possibility. People with narcolepsy often experience what’s called “fragmented nighttime sleep,” which basically means their sleep is broken up with frequent awakenings, sometimes with difficulty falling back asleep. Sound familiar? That’s insomnia.

It’s important to know that narcolepsy doesn’t guarantee deep, restful nighttime sleep. In fact, many people with narcolepsy report sleeping in short bursts, having vivid dreams that wake them up, or struggling to settle down at night despite being exhausted. All of these can overlap with classic insomnia symptoms.

So yes, having narcolepsy doesn’t give you a pass on insomnia. You can absolutely be dealing with both—and if that’s your situation, you’re definitely not alone.

Signs You Might Have Both Narcolepsy and Insomnia

Let’s say you’re tired all day but also tossing and turning all night. That could be more than just a rough patch—it might be both narcolepsy and insomnia showing up at once. Here are some common signs:

You feel unbearably tired during the day

This is one of the hallmark signs of narcolepsy. It’s not just feeling a little sleepy—it’s that overwhelming urge to nap, even in inappropriate settings like at work or while driving.

You fall asleep easily… but wake up a lot at night

Many people with narcolepsy fall asleep quickly (sometimes too quickly), but their sleep isn’t solid. You might wake up multiple times, sometimes for no clear reason.

You struggle to fall back asleep

Even though narcolepsy is associated with sleepiness, that doesn’t mean you’re immune to insomnia-style tossing and turning.

Your dreams are vivid or even disturbing

Narcolepsy is often tied to REM sleep disturbances. That means people may enter REM sleep quickly, have intense dreams, or even experience sleep paralysis or hypnagogic hallucinations—which can make nighttime feel more unsettling than restful.

You dread bedtime

When you’re dealing with both narcolepsy and insomnia, bedtime can start to feel like a battle. You’re tired, but not relaxed. You want to sleep, but your brain won’t cooperate.

If you nodded along to a bunch of those, it might be time to talk to a sleep specialist—because there are ways to improve this.

FAQs About Narcolepsy and Insomnia

Can narcolepsy cause insomnia?

Yep, it can. One of the lesser-known symptoms of narcolepsy is fragmented nighttime sleep, which means frequent awakenings and difficulty staying asleep. Some people even struggle to fall asleep, despite feeling exhausted.

Is insomnia a symptom of narcolepsy or a separate condition?

It can be either. For some, insomnia is directly tied to their narcolepsy. For others, it may be a co-existing condition—meaning they just got extra unlucky in the sleep department. Either way, both conditions deserve attention and treatment.

How do doctors diagnose both conditions?

If you’re experiencing both excessive daytime sleepiness and poor nighttime sleep, a sleep specialist may recommend a polysomnography (sleep study) followed by a Multiple Sleep Latency Test (MSLT). These tests help determine how fast you fall asleep and how quickly you enter REM sleep, which are key indicators of narcolepsy.

Doctors may also ask you to keep a sleep diary, track symptoms, or use an actigraphy watch to monitor your sleep-wake patterns over time.

Can you treat both at once?

Absolutely. In fact, successful treatment usually involves addressing both issues. You might need medications like stimulants (to help with daytime sleepiness) and possibly low-dose antidepressants or sedatives (to help with nighttime sleep).

But lifestyle adjustments are equally important. Things like consistent bedtime routines, avoiding caffeine late in the day, and using relaxation techniques can go a long way.

What’s the difference between narcolepsy with fragmented sleep and insomnia?

Good question. It often comes down to why your sleep is disturbed. In narcolepsy, sleep is disrupted by changes in brain chemistry—specifically, a loss of hypocretin, which helps regulate wakefulness and REM sleep. In insomnia, the cause is often psychological (like stress or anxiety), behavioral (like poor sleep habits), or environmental.

Are people with both conditions at greater risk for mental health issues?

Yes. Sleep and mental health are deeply connected. People with narcolepsy and/or insomnia may face increased risk of depression, anxiety, mood swings, and even social isolation due to the challenges of managing unpredictable sleep.

Getting proper care for both conditions isn’t just about getting more Zzz’s—it’s about protecting your overall well-being.

Conclusion

So, can you have narcolepsy and insomnia at the same time? The answer is a resounding yes. And while it may seem contradictory—being overly sleepy and unable to sleep—it’s actually a well-documented reality for many people.

If this sounds like your experience, know that you’re not imagining it, and you’re definitely not alone. The first step is to talk to a sleep specialist who can help sort out what’s going on and tailor a treatment plan that addresses both daytime and nighttime issues.

Living with both narcolepsy and insomnia can be challenging, but it’s not hopeless. With the right support, smart sleep habits, and maybe a little help from modern medicine, you can absolutely improve your sleep—and your life.