Dr. Matt Walker

It reaches down into the, it's released from a central part of your brain called the hypothalamus, and it releases down into the brainstem to activate what we call the ascending arousal system or the reticular ascending arousal system of the brain.

And when that lights up, it's like the light switch, which says on for waking brain activity.

And so what was happening was that this orexin up higher up was not forcing the finger of wakefulness on during the day.

So almost instead of a switch, which is what you want, it was more like a dimmer switch.

And you know, when you get to that dimmer switch point right in the middle where it's flickering, it's on, it's off, it's on, it's off.

That's almost the state in which the narcoleptic brain was because they had a deficiency of orexin.

So that was the orexin story in narcolepsy.

So why is it relevant for insomnia?

Well, people realized the problem with narcolepsy is that they're asleep during the day when they want to be awake.

But the opposite problem is true of insomnia patients.

They want to be asleep at night, but they're awake.

So why don't we selectively develop a drug that goes after this finger that flips the light switch on for wakefulness, but now let's block it at night.

So we flick the switch back in the off position.

We turn out the lights for the brain and we remove the problem of insomnia, which is excessive wakefulness at night, which is one of its problems, but...

And therefore, when you remove that indirectly, what comes in its place is this thing called more naturalistic sleep.

And that's why it's been more favored now as the principal drug.

It's still not necessarily well known by physicians or it's not very well prescribed.

It's not very well covered here in the United States, unfortunately, with insurance.

So it's a very expensive option right now.

Health providers will choose not to do that, unfortunately.