Orexin-A/Hypocretin-1 for the Diagnosis of Type 1 Narcolepsy [Test in Focus]

The standard test for the diagnosis of narcolepsy is the multiple sleep latency test (MSLT). The MSLT is a complex test to perform as well as to interpret. The orexin-A/hypocretin-1 test is a sensitive and specific alternative to the MSLT to diagnose type 1 narcolepsy.

A Clinical Perspective

Michael Silber, M.B., Ch.B., a neurologist in the sleep medicine department at Mayo Clinic, provides a clinical perspective of narcolepsy, discussing limitations of current testing methods and the advantages of ordering the orexin-A/hypocretin-1 test.

Suresh Kotagal, M.D., a pediatric neurologist at Mayo Clinic, discusses how he uses the orexin-A/hypocretin-1 test in his practice.

A Laboratory Perspective

The Stanford Sleep Diagnostic Center was a pioneer of this assay and helped lay the groundwork for the development of this test. Joshua Bornhorst, Ph.D., a director in the clinical biochemistry laboratory at Mayo Clinic, discusses this test from a laboratory perspective and explains the role Mayo Clinic played in the development and validation of this test.


When to Order

  • To aid in the diagnosis and differentiation of type 1 narcolepsy from other causes of hypersomnolence.
  • This assay is not intended for use as a screening test.

Specimen Information

Patient Preparation: Patient should not have recently received radioisotopes, either therapeutically or diagnostically, due to potential assay interference.

Collection Container/Tube: Sterile vial

Submission Container/Tube: CSF in plain vial with no additives

Specimen Volume: 1.5 mL

Pediatric Volume: 0.5 mL minimum volume

Collection Instructions:

1. Obtain aliquot from second collection vial (preferred, not required).

2. Hemolyzed specimens will give false-positive results. Specimens should be centrifuged to remove any red cells prior to shipping.

Performance Information

Day(s) and Time(s) Test Performed 

Tuesday, 8 a.m.

Analytic Time 

3 days

For more information on how to order the
orexin-A/hypocretin-1 test at your institution,
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Alyssa Frank

Alyssa Frank is a Marketing Segment Manager at Mayo Clinic Laboratories. She leads marketing strategies for product management and specialty testing. Alyssa has worked at Mayo Clinic since 2015.