Insomnia Drug Develops from Narcolepsy Research

What do people with insomnia and people with narcolepsy have in common? Trick question! I don’t know, but we may be coming closer to an answer.

In the late 90’s, narcolepsy researchers made a significant breakthrough in successfully identifying the brain cells, called hypocretin (or orexin), that go missing in those that develop narcolepsy.  These brain cells help to control the sleep/wake cycle, so when they disappear, the sleep/wake cycle is not properly regulated and symptoms of narcolepsy develop.

Narcolepsy researchers continue to study this brain cell loss, trying to figure out why the degeneration takes place (now believed to be an autoimmune response due to multiple genetic and environmental co-factors).

The big breakthrough has yet to lead to better treatments for narcolepsy, but the potential is huge. “If we could get orexin into the brains of people with narcolepsy – and get it to the right places at the right times – we could, I think, completely cure this disease,’’ Dr. Thomas Scammell, a neurologist and prominent narcolepsy specialist at Beth Israel Deaconess Medical Center told the Boston Globe, “It would be like giving insulin to diabetics.’’(1)

Despite the potential, there has been little interest from the pharmaceutical industry in developing this possible “cure” at this point. However, another patient population may benefit.  At least one pharmaceutical company hopes to capitalize on narcolepsy research – for people with insomnia.

Merck has worked for the past eight years on a novel insomnia drug that affects the hypocretin/orexin system, reports an informative news article today. Other insomnia medications bind with either GABA or melatonin receptors, which help people fall asleep, but don’t necessarily keep them asleep. Instead, Merck’s pipeline drug, called suvorexant, works by “binding to the brain’s orexin receptors and blocking hormones known as orexin peptides from signaling the body to wake up.”(2)

Merck’s suvorexant drug is currently in stage III clinical trials, estimated to wrap up in September 2011. (3)

Yet, the fate of suvorexant is still unclear. “Results of mid-stage studies showed the drug was ‘generally well-tolerated,’ according to a press release issued by Merck last year. Some of the side effects reported by study participants included upper respiratory tract infections, dizziness and vivid dreams.”(2)

Vivid dreams?! Hmm, sounds familiar.  I hope Merck’s drug isn’t just a dose of narcolepsy. Or wait, is that the point? (I hope this drug gives individuals a healthy sleep architecture and simply isn’t putting them into REM.)

In all seriousness, I’m interested to watch the medication’s progress. The market potential for a successful insomnia treatment is huge (in 2010, total insomnia market value was $2.73 billion).  I expect we will hear a lot more about this drug in the future.

Beyond the interests of the sleep-challenged amongst us, this story is important for exemplifying the unpredictable nature of scientific research. A discovery for narcolepsy may lead to an advancement for insomnia. There is also great potential for hypocretin/orexin-targeted treatments to help obesity and addiction. (3)

I hope narcolepsy has good karma for helping other disorders, and that this comes back our way eventually!


(1)”Narcolepsy Research Triggers Myraid Brain Studies,” by Carolyn Johnson, Boston Globe, Nov. 30, 2009.
(2)Eight years in the making, N.J.-based Merck developing new kind of insomnia drug,” by Susan Ledger, The Star-Ledger, July 3, 2011.


  1. Anonymous on July 3, 2011 at 7:45 pm

    Guess its still a question of whether it's a sleeping pill that get's us the right kind of sleep….

    First PSG noted the lack of the deeper, more restful phases of sleep, most likely due to OSA… And, confirmed it with an AHI of 34.1. Conclusion, OSA and get a CPAP.

    Two years later, second PSG noted the same lack of the deeper,more restful phases of sleep, most likely due to OSA….but recorded an AHI of 0.0…. Conclusion, OSA and continue with CPAP.

    Was on 1mg of Lunesta.

    Though did eventually get to hear the phrase idiopathic hypersomnia…. But, no real change in sleep aid (went to 2mg and now 3mg)….though the Provigil that had stopped working was replaced with Ritalin….which doesn't work enough.

    Though boss seems okay that I'm in for lunch and then too sleepy to risk going home so I stay late, and then nap at 10pm so I can be night owl for 3-4 hours. Though the tone of my emails after 4pm is kind of a problem.

    Silly PSG also says to avoid alcohol at bedtime, didn't matter that I told them I hadn't had a drink in almost 15.5 years (now over 16 years).

    Meanwhile, the other colleague that had the pleasure of experiencing most of the same tests I've gone through ahead of me was terminated a couple weeks ago. Which I'm told was due to performance reviews…. and not being able to figure out what is wrong and getting a treatment that works.

  2. Robert M. Burnside on July 4, 2011 at 9:22 am

    Julie, thanks for keeping up with the developments in the pharma industry, let's hope they eventually find a cure!

  3. sbeaulieu on July 4, 2011 at 2:22 pm

    so interesting to read about! Thanks for posting it.
    I would love to be able to one day sleep the whole night through! Some nights i just have super bad insomnia, which ends up being contradicting to my narcolepsy; forcing me to have to nap more the next day!
    I hope one day they find something that cures at least one of the two! I could manage better with just one sleep disorder! =p

  4. SemperFiVet on July 28, 2011 at 10:29 pm

    I believe we need an orexin antagonist like what GSK was recently developing, this one unfortunately sounds like N. in a pill form! I was diagnosed while in the military in my early 20's, I sure hope and pray for the day when we can control N. like a diabetic does via insulin!

  5. […] julie on June 14, 2012 An upcoming insomnia medication, Suvorexant develped from our understanding of narcolepsy. At SLEEP 2012 Conference today, Merck announced results for additional clinical trials – […]

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