Narcolepsy & Idiopathic Hypersomnia Treatment in Austin
You're not "just tired" or "just stressed."
Living with Narcolepsy or Idiopathic Hypersomnia is different from ordinary fatigue. These neurological sleep disorders affect your brain's ability to regulate sleep and wakefulness—and they deserve treatment that's designed for what you're actually experiencing.
Hypersomnia is a newer area of focus within my behavioral sleep medicine practice. My education includes an introduction to hypersomnia disorders through the Society of Behavioral Sleep Medicine, four hours of focused training in Idiopathic Hypersomnia with Dr. Jason Ong, and ongoing behavioral sleep medicine consultation with Dr. Donn Posner. I provide care informed by the structured CBT-H treatment manual and have worked individually with adults diagnosed with narcolepsy and idiopathic hypersomnia.
I am a member of the Society of Behavioral Sleep Medicine and American Academy of Sleep Medicine
Jessica Fink, LCSW-S (license #50905) provides CBT for Hypersomnia in Austin and across Texas via online therapy
If you have Narcolepsy or Idiopathic Hypersomnia, you've probably heard some version of these comments:
"We're all tired."
"I wish I could sleep like you do."
"Maybe you just need more sleep so you're not so tired all the time."
"But you look fine."
Or perhaps the one that hurts the most:
"You just don't care enough."
Some of these comments are attempts to be helpful. Some are probably made out of frustration and lack of understanding. They all sting.
Because ordinary tiredness and a neurological sleep disorder are not the same thing. You are living with a condition that affects your brain's ability to regulate sleep and wakefulness. That’s an important distinction.
Medication Is Essential—And It Isn't the Whole Picture
For most people with Narcolepsy or Idiopathic Hypersomnia, medication is a cornerstone of treatment.
I want to be very clear that Behavioral Sleep Medicine is not a replacement for medical care.
I work alongside sleep physicians, not in place of them.
Medication can make an enormous difference in excessive daytime sleepiness and, for people with narcolepsy type 1, cataplexy.
But medication doesn't have an answer for questions like:
How do I manage my energy throughout the day?
How do I decide what deserves my limited energy?
How do I explain this condition to my employer?
How do I advocate for accommodations at work or school?
How do I stop feeling guilty for needing rest?
How do I build a satisfying life around a chronic neurological condition?
Those are the kinds of questions we work on together.
You only get
so many spoons
One of my favorite ways to think about hypersomnia comes from the "spoon theory."
Writer and blogger Christine Miserandino developed this framework to describe her experience living with lupus, and I think it applies beautifully to Narcolepsy and Idiopathic Hypersomnia.
Imagine you begin every morning with a limited number of spoons.
Every task costs one or more spoons. Getting dressed. Driving to work. Attending meetings. Making dinner. Socializing.
Most people wake up with enough spoons that they rarely think about them.
With Narcolepsy or Idiopathic Hypersomnia, you're starting the day with fewer spoons. You don't fail because you're lazy. You just run out of spoons.
Part of treatment is learning how to spend that energy intentionally, protect it when possible, and decide which activities matter most to you.
Why This Can Feel So Isolating
One of the hardest parts of living with hypersomnia is that the illness is largely invisible.
People see you looking tired. They don't see your internal battle to stay awake.
They see you cancel plans. They don't see the careful calculations you've already made about whether you have enough energy to make it through the evening.
They see someone who looks healthy. They don't see someone managing a lifelong neurological disorder.
The constant misunderstanding adds another level of difficulty.
What Is CBT-H?
I use Cognitive Behavioral Therapy for Hypersomnia (CBT-H), a structured behavioral treatment designed specifically for people with Narcolepsy and Idiopathic Hypersomnia.
My approach is informed by the CBT-H treatment manual developed through research supported by the American Academy of Sleep Medicine Foundation. Treatment is adapted to your individual needs and provided alongside—not in place of—medical care from your sleep physician.
CBT-H doesn't aim to cure these disorders because they aren't currently curable.
Instead, treatment focuses on improving quality of life by helping you:
manage your available energy
build routines that work with your condition
reduce the impact of symptoms on daily life
advocate for yourself with confidence
solve practical challenges at work, school, and home
develop strategies that complement your medical treatment
Every recommendation has a reason. I'll explain why we're trying something before asking you to do it.
Quoted expert on hypersomnia treatment
I recently contributed to Dreem Health’s article, “Hypersomnia Treatment: How Doctors Actually Treat Excessive Sleepiness,” discussing how CBT-H complements medication and helps people manage energy, daily functioning, and the emotional effects of living with narcolepsy or idiopathic hypersomnia.
Why I Offer CBT-H
I began my work in behavioral sleep medicine by treating insomnia. As sleep became a larger part of my practice, I quickly learned that sleep disorders don’t always show up alone. People seeking help for insomnia may also be living with nightmares, sleep apnea, circadian rhythm problems, Narcolepsy, or Idiopathic Hypersomnia.
I began studying CBT-H because I wanted to offer more than one narrow piece of behavioral sleep care. Adults with Narcolepsy and Idiopathic Hypersomnia need support that recognizes both the biology of their condition and its effects on work, relationships, identity, and daily life. My goal is to provide that specialized behavioral support alongside—not in place of—their medical treatment.
What Treatment Is Like
We'll begin by understanding how hypersomnia affects your life. No two people manage these disorders exactly the same way.
Together we'll identify the situations that drain your energy, the strategies you've already developed, and the areas where you'd like life to feel more manageable.
Treatment isn't about pretending your disorder doesn't exist. It's about helping you build a life that works with it instead of constantly fighting against it.
Is CBT-H Right For You?
Treatment may be a good fit if:
you've been diagnosed with Narcolepsy or Idiopathic Hypersomnia
medication helps but you still struggle with day-to-day functioning
you're looking for practical strategies beyond medication
you're tired of feeling misunderstood by the people around you
you want to improve your quality of life without having to act like your condition doesn't exist
You Don't Have to Figure This Out Alone
Living with hypersomnia often means constantly making trade-offs about how to spend your limited energy. Those decisions aren't always obvious. And they're rarely something anyone teaches you.
The goal isn't to eliminate your condition. It's to help you make sense of it, work with it, and build a life that reflects what's most important to you.
Frequently Asked Questions About Hypersomnia Treatment
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Hypersomnia is a medical symptom involving excessive daytime sleepiness. It can be caused by another medical condition, a medication, a substance, or it can be its own disorder, which is the case for Narcolepsy and Idiopathic Hypersomnia.
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Fancy medical speak for “yep, you’re sleepy all the time, it’s adversely impacting your life, and we don’t know why.” After other causes of sleepiness are ruled out, someone might be given this diagnosis. it’s debated whether IH is a form of Narcolepsy II.
The American Academy of Sleep Medicine provides a helpful patient overview of Idiopathic Hypersomnia, including common symptoms, diagnosis, and medical treatment.
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Yes, primarily as an adjunct to standard care. Standard care for hypersomnia disorders is medication, but medication can’t address all of the quality-of-life frustrations of having a hypersomnia disorder. That’s why CBT-H was developed.
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CBT-H is a form of cognitive behavioral therapy developed specifically for people with Narcolepsy and Idiopathic Hypersomnia. It was designed to pick up where medication leaves off. Medication may reduce excessive daytime sleepiness and, for people with narcolepsy type 1, cataplexy, but it does not necessarily address the emotional, social, and occupational effects of living with a chronic sleep disorder.
CBT-H is different from CBT-I. CBT-I targets difficulty falling or staying asleep and often includes strategies such as sleep restriction and stimulus control. CBT-H focuses instead on managing available energy, structuring daytime routines, using naps strategically when appropriate, coping with unpredictable symptoms, advocating for support, and improving quality of life. It complements medical treatment rather than replacing it.
CBT-H is a newer treatment with a developing evidence base. An initial peer-reviewed feasibility study of CBT-H found preliminary improvements in depressive symptoms and confidence in managing unpredictable or stressful situations among adults with Narcolepsy or Idiopathic Hypersomnia.
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Yes! CBT-H is designed for Narcolepsy I, Narcolepsy II, and Idiopathic Hypersomnia.
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Yes. CBT-H is intended for people who have been formally diagnosed with Narcolepsy or Idiopathic Hypersomnia. If you suspect you may have one of these disorders, the first step is to speak with a sleep physician or neurologist who can rule out other causes of excessive sleepiness and determine which testing is appropriate. As a therapist, I cannot diagnose narcolepsy or idiopathic hypersomnia.
Once you have a diagnosis, I provide behavioral treatment alongside—not in place of—medical care. Medication management and CBT-H serve different but complementary roles. With your written permission, I can also coordinate care with your sleep physician or neurologist.
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That’s not the intention. But, that said, I have clients who just don’t like stimulants, and I will not force you to be on medication to do CBT-H. Just know it may be more difficult to manage the symptoms without medication.
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Yes! If you are located in Texas at the time of our sessions, I can see you.