Narcolepsy (NC) is a rare chronic neurological disorder. Current western medical treatments (such as central stimulants, antidepressants, and sodium gamma-hydroxybutyrate) primarily aim to reduce excessive daytime sleepiness, control cataplexy, and improve nighttime sleep, thereby alleviating clinical symptoms. However, long-term use of western medications may lead to issues such as drug dependence, drug resistance, and adverse effects. In contrast, traditional Chinese medicine (TCM), guided by the principles of "treatment based on syndrome differentiation" and "holistic regulation", offers unique advantages in improving NC symptoms, reducing the risk of disease recurrence, and enhancing quality of life. It can compensate for the limitations of western medicine, reduce dosage requirements of western drugs, and mitigate their side effects, thereby improving treatment safety. Additionally, TCM may delay cognitive impairment and protect brain function. Therefore, this study systematically reviews recent advances in both western medicine and TCM for the treatment of NC, and further explores the benefits of integrated western and TCM approaches under a holistic medical model, with the aim of optimizing clinical strategies and providing new insights for the management of NC.