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World Sleep 2022 | Orexin in narcolepsy – a constellation of related symptoms

Kiran Maski, MD, MPH, Boston Children’s Hospital, Boston, MA, discusses the role of orexin in the symptomatic expression of narcolepsy. It is known that orexin is a causal factor in narcolepsy type-1, yet it is not known precisely why. It is thought to be related to an autoimmune process; there is a high association between the HLA-DQ1B*602 gene and narcolepsy type-1 – with associations to various illnesses such as strep, the flu, and even vaccinations with the onset of narcolepsy. Dr Maski states that orexin is important for wake-sleep stabilization – learning that it is also related to several other autonomic, cognitive, behavioral, and motivational processes. This might explain the constellation of symptoms experienced by patients with narcolepsy – including autonomic dysfunction, difficulty with concentration, attention, executive functioning, motivation, and potential weight gain. This interview took place at the World Sleep Congress 2022 in Rome, Italy.