Narcolepsy is a chronic neurological disorder of rapid onset eye movement (REM) sleep, affecting the sleep-wake cycle in the brain. It is characterized by excessive daytime sleepiness, uncontrollable sleep attacks, and sleep fragmentation and is often associated with cataplexy, sleep paralysis, and hypnagogic hallucinations. Consequently, the disorder has significant morbidity and as there are currently inadequate treatment options, it is imperative for there to be extensive research into the development of efficacious treatments. Currently, research has focused on the development of pharmacological agents which target the underlying pathophysiological processes involved in narcolepsy. For example, one of the hallmarks of narcolepsy type 1 is the selective loss of orexin-producing neurons in the hypothalamus leading to lower levels of orexin in the cerebrospinal fluid. Therefore, multiple studies have concentrated on the development of drugs targeting the orexin system to prevent the loss of orexin producing neurons.

In this week’s podcast, Claudio Bassetti, MD, Inselspital, Bern, Switzerland; Emmanuel Mignot, MD, PhD, Stanford University Center for Sleep Sciences, Palo Alto, CA; and Kiran Maski, MD, MPH, Boston Children’s Hospital, Boston, MA, discuss current understanding of narcolepsy and the potential for future treatment interventions