We’re Taking the First Steps Toward a Cure for Narcolepsy
So, will the tale of the orexins really have a happy ending? The translation of basic research into the clinic is notoriously difficult and expensive, says Casper. (The cost of the current best available treatment for narcolepsy–sodium oxybate, or Xyrem–is such that it is not routinely available for adults in England, even though it could transform the lives of many.)
There is a widespread perception that narcolepsy is a rare disorder with a small market, so any pharmaceutical research and development in this area would be unlikely to reap a significant return. This ignores the fact that narcolepsy is probably undiagnosed in many people, and that someone who develops narcolepsy in their teens and lives into their 80s would need some 25,000 doses over their lifetime.
Even more compellingly perhaps, the orchestrating role that the orexins play in the brain suggests the market for such a drug would go far beyond narcolepsy. Something that tickled up the orexins would be useful for any condition where excessive daytime sleepiness is an issue, not to mention the myriad other situations where low levels of these messengers may play a role, including obesity, depression, post-traumatic stress disorder, and dementia.
There is, I believe, one other reason why this story has not yet reached its conclusion. For too long, sleep has been undervalued, seen as an inconvenient distraction from wakefulness. With this mindset, research into the neuroscience of sleep does not seem like it should be a priority. Nothing could be further from the truth. There is now abundant evidence that poor sleep can have devastating consequences for physical, mental and psychological health. Sleep is not incidental. It is fundamental, a matter of serious public health. Investing in sleep research is not just about the few with demonstrable sleep disorders. It is about everyone.
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