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Orexin receptor antagonists in the pathophysiology and treatment of sleep disorders and epilepsy

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卷 99, 期 -, 页码 -

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DOI: 10.1016/j.npep.2023.102335

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Orexin; Orexin receptor antagonist; Sleep; Sleep disorders; Seizure; Epilepsy

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The correlation between sleep and epilepsy has been debated among scientists for many years. Sleep is a recurring state of mind and body that involves alternations in brain electrical activities. Sleep disorders are associated with epilepsy, which affects the origin, suppression, and spread of seizures. Orexin, a neuropeptide involved in wakefulness, has bidirectional effects on sleep and epilepsy. Understanding the relationship between sleep, epilepsy, and orexin is important for developing potential therapeutic strategies.
The correlation between sleep and epilepsy has been argued over the past decades among scientists. Although the similarities and contrasts between sleep and epilepsy had been considered, their intertwined nature was not revealed until the nineteenth century. Sleep is recognized as a recurring state of mind and body through alternating brain electrical activities. It is documented that sleep disorders are associated with epilepsy. The origin, suppression, and spread of seizures are affected by sleep. As such, in patients with epilepsy, sleep disorders are a frequent comorbidity. Meanwhile, orexin, a wake-promoting neuropeptide, provides a bidirectional effect on both sleep and epilepsy. Orexin and its cognate receptors, orexin receptor type 1 (OX1R) and type 2 (OX2R), orchestrate their effects by activating various downstream signaling pathways. Although orexin was considered a therapeutic target in insomnia shortly after its discovery, its potential usefulness for psychiatric disorders and epileptic seizures has been suggested in the pre-clinical studies. This review aimed to discuss whether the relationship between sleep, epilepsy, and orexin is clearly reciprocal.

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