Have you ever found a frying pan in your freezer? Put your car keys in the refrigerator? Discovered your toothbrush in the laundry hamper? If so, you may be seeing the result of an automatic behavior.

Even though up to 80 percent of people with narcolepsy experience automatic behaviors, this symptom is poorly understood. Continue reading to learn more about automatic behaviors in narcolepsy.

What Are Automatic Behaviors?

An automatic behavior is an activity you do without being aware of it. Episodes of automatic behavior can occur while you’re doing something monotonous or that doesn’t require skill, especially if it’s a regular activity. Your level of alertness and awareness may be reduced, and you act automatically. Before an automatic activity, you might feel sleepy and fatigued.

People who’ve experienced automatic behaviors often describe a blank spot in their memory during the activity. In a 2013 study in The Open Sleep Journal, people with narcolepsy described the following types of automatic behaviors:

• Eating
• Talking
• Writing
• Cooking
• Driving

A common example of an automatic behavior involves continuing to write or type with limited awareness, leading to lower performance and mistakes. People have also reported putting items in locations they don’t belong — such as placing a pan in the freezer. One 1979 case report described someone with narcolepsy who had a unique automatic behavior of shoplifting. Most people don’t remember what happened during these episodes.

Who Experiences Episodes of Automatic Behavior?

Although automatic behaviors are often discussed as a possible symptom of narcolepsy, they can also occur in people without narcolepsy.

A common example of automatic behavior is highway hypnosis, which is described as a lost sense of time while driving. You may arrive at your destination without remembering details about your journey. Highway hypnosis can happen to anyone and is more likely to occur if you’re following a very familiar route or taking a long, monotonous road trip.

Automatic behaviors have also been reported in people taking a medication called pramipexole (Mriapex) to treat Parkinson’s disease.

Why Do Automatic Behaviors Happen in Narcolepsy?

Researchers believe episodes of automatic behavior are likely associated with interruptions in rapid eye movement (REM) sleep, non-REM sleep, or other sleep disorders. Although automatic behavior is recognized as a symptom of narcolepsy, it’s difficult to study in a lab.

In the 2013 study, researchers from Australia used questionnaires, journals, and interviews with people with narcolepsy and their family members to help describe automatic behaviors. This study linked episodes with some common factors, including feeling sleepy, using medication, and experiencing stress.

Sleepiness

You may be more likely to experience an episode of automatic behavior if you’re sleepy. Everyone diagnosed with narcolepsy experiences excessive daytime sleepiness — also known as hypersomnia. “All of my behavior has been in automatic mode,” shared a MyNarcolepsyTeam member.

If you’re tired when you start a routine activity such as eating, writing, or driving, you may perform with reduced awareness. The automatic behavior might stop if you fall asleep or regain alertness. An unexpected event (for example, putting your hand — instead of the food you were cooking — in a pot of boiling water) can also cause you to regain awareness.

Automatic behaviors don’t always coincide with sleepiness. A MyNarcolepsyTeam member shared a time they experienced automatic behaviors without feeling sleepy: “Rough night last night. I was up at 3 a.m. and fighting off wakefulness but with automatic behaviors.”

Stress

Additional stress can increase the likelihood of automatic behavior episodes. People with narcolepsy have described automatic behavior if they are stressed either when sleepy or when feeling well rested.

Medication

Daytime sleepiness from narcolepsy is often treated with stimulant medications. Episodes of automatic behavior could be more likely if your medication is wearing off, you don’t take your medication appropriately, or you’re not taking the correct dose. Inappropriate medication use may affect you for several days.

How Can Automatic Behaviors Be Controlled?

Some people may be hesitant to report automatic behaviors because they’re worried about being embarrassed or appearing lazy. Don’t be afraid to talk to your medical team about automatic behaviors. You can’t get treatment if you don’t share details of your symptoms.

“I have the most wonderful, understanding sleep specialist! I confessed everything to him about my automatic behavior and every other aspect of my life with narcolepsy,” shared a MyNarcolepsyTeam member.

Manage Narcolepsy Symptoms

Managing automatic behaviors starts with managing other symptoms of narcolepsy, such as sleep attacks (overwhelming sleepiness) and cataplexy (sudden loss of muscle control). A doctor specializing in sleep medicine can help you identify your symptoms and find the best treatment options for you.

A sleep study — also known as a polysomnogram (PSG) — can help determine if your symptoms are caused by interruptions in your sleep cycle. A multiple sleep latency test (MSLT) can assess your daytime sleepiness. Your doctor may ask you to keep a sleep journal to help you track your symptoms.

Take Medication Appropriately

Medication can help you manage narcolepsy symptoms, including automatic behavior. Common medications used to treat narcolepsy include:

• Modafinil (Provigil)
• Methylphenidate hydrochloride (Ritalin, Concerta, and others)
• Antidepressants, such as venlafaxine (formerly sold as Effexor), fluoxetine (Prozac), and clomipramine (Anafranil)
• Sodium oxybate (Xyrem)
• Pitolisant (Wakix)

Talk to your medical team about how to take your medication, how long you can expect your medication to last, and the side effects.

Make Lifestyle Changes

Ask your medical team about other ways to manage automatic behaviors. People in the 2013 Australian study described several strategies that help them manage automatic behaviors. Based on the participants’ experiences, you might prevent an episode if you:

• Take a nap — You may be able to avoid a drowsiness-related episode if you stop what you’re doing and take a short nap. This strategy may not help if you don’t know you’re sleepy or if you’re under pressure to complete a task.
• Develop useful habits — If you find that you lose track of items during episodes, it may help to follow habits that avoid negative outcomes. For example, you could try to always put your car keys in the same place.
• Reduce stress — Time-management strategies could help you avoid automatic behaviors due to stress.
• Stay active — Moving around when you’re fighting sleepiness, such as getting up for a drink of water or taking a short walk, might ward off an automatic behavior.

Talk With Others Who Understand

MyNarcolepsyTeam is the social network for people with narcolepsy and their loved ones. On MyNarcolepsyTeam, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with narcolepsy.

Do you experience automatic behaviors? How do you manage your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.