Driving performance in narcolepsy patients is often affected. This is predominantly caused by excessive daytime sleepiness and disturbed vigilance. To a lesser extent cataplexy and sleep paralysis may play a role as well.
This chapter discusses experimental studies assessing driving performance in both treated and untreated patients with narcolepsy. Driving simulator studies and psychological test batteries show that untreated narcolepsy may significantly impair driving ability and increase the risk of becoming involved in traffic accidents. However, much more research is needed to evaluate the effects of narcolepsy treatment on actual driving in real traffic, and epidemiological evidence on traffic accident risks should be performed in future. Relatively few studies have been performed to examine effects of narcolepsy treatment on driving ability. Up to now driving improvement has been demonstrated in patients who are successfully treated with methamphetamine. Future driving studies should examine the effect of other treatment options.