Mayo Clinic Laboratories > Neurology > Neurogenetics > Sleep disorders

Sleep disorders

Identify and guide treatment for type 1 narcolepsy

For individuals affected by narcolepsy, analysis of orexin, a neuropeptide produced in the hypothalamus and involved in the sleep/wake cycle, can help establish diagnosis. Impairment of orexin production and orexin-modulated neurotransmission is associated with narcolepsy with cataplexy, and an abnormally low concentration of orexin-A/hypocretin-1 in cerebrospinal fluid (CSF) is indicative of type 1 narcolepsy. Determining orexin-A/hypocretin-1 levels through CSF testing provides a sensitive and specific result to guide appropriate treatment for patients.

85%-95%

85%-95% of individuals with type 1 narcolepsy and typical cataplexy exhibit low CSF orexin concentrations

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Advantages

  • Aids in the diagnosis and differentiation of type 1 narcolepsy from other causes of hypersomnolence.
  • Especially helpful for patients suspected of narcolepsy for whom a multiple sleep latency test (MSLT) is difficult to interpret due to shift work, lack of sleep, confounding medications, or the presence of untreated or partially treated sleep apnea. It can also be helpful in patient of a young age for whom MSLT is not valid on its own.

Highlights

Sleep Review explores orexin testing for narcolepsy with Joshua Bornhorst, Ph.D.

Dr. Bornhorst explains orexin testing's role in diagnosing type 1 narcolepsy and the significance of the test's availability through Mayo Clinic Laboratories.

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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.

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References
  1. Bourgin P, Zeitzer JM, Mignot E. CSF hypocretin-1 assessment in sleep and neurological disorders. Lancet Neurol. 2008 Jul;7(7):649-662. doi:10.1016/S1474-4422(08)70140-6
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