It can have a significant negative effect. As they struggle with exhaustion and sleep disruption, children and adolescents with narcolepsy often develop aggression or other behavioral problems that make friendships a challenge. At any age, an individual may experience social isolation because of episodes of cataplexy, or they may avoid social commitments out of fear that episodes could occur. As one enters college and the workforce, increased professional and social demands may reduce one’s available time for nighttime sleep, further disrupting the sleep-wake cycle and exacerbating symptoms. The effort to exert control over one’s emotions to avert cataplexy can also make social connections a struggle.