How hypocretin agonists may improve the quality of wake in narcolepsy |
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| Institution: | 1. Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark;1. Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA;2. Department of Chemistry, University of Michigan, Ann Arbor, MI 48109, USA;3. Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA;4. Department of Chemical Engineering, University of Michigan, Ann Arbor, MI 48109, USA;5. Biointerfaces Institute, University of Michigan, Ann Arbor, MI 48109, USA;1. Department of Microbiology and Immunology, The University of Western Ontario, London, ON, Canada;2. Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA;3. Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA;4. Department of Otolaryngology, Head & Neck Surgery, The University of Western Ontario, London, ON, Canada;5. Department of Oncology, The University of Western Ontario, London, ON, Canada;6. London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada;1. Department of Biomedical Engineering, Duke University, Durham, NC, USA;2. Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA;1. CNC - Center for Neuroscience and Cell Biology, CIBB - Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal;2. IIIUC - Institute of Interdisciplinary Research, University of Coimbra, Coimbra, Portugal;3. Department of Molecular Genetics, Faculty of Science and Engineering, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands;4. FMUC - Faculty of Medicine, University of Coimbra, Coimbra, Portugal;5. PhD Programme in Experimental Biology and Biomedicine, Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal;1. Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland;2. University of Basel, Petersplatz 1, 4001 Basel, Switzerland |
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| Abstract: | Excessive daytime sleepiness (EDS) is a complex symptom characterized by a strong urge to sleep during daytime accompanied by problems such as attention deficits, anxiety, and lower cognitive performance. The efficacy of treatments for EDS is determined by their ability to decrease sleepiness, and less attention has been given to the effects these compounds have on the quality of the wake itself. Hypocretin (HCRT; orexin) signalling is implicated in narcolepsy, and hypocretin receptor 2 (HCRTR2) agonists are in clinical trials for treating EDS in narcolepsy. Here, we review preclinical research to determine how HCRTR2 agonists may affect attention and anxiety compared with other EDS treatment strategies. We conclude that such compounds may improve not only the quantity but also the quality of wake, and we hope that they will create opportunities for more nuanced treatment strategies in narcolepsy. |
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