MOVING BEYOND SLEEP: THE BROADER CONNECTION BETWEEN THE OREXIN SYSTEM AND PSYCHIATRIC DISORDERS

In clinical practice, sleep and psychiatric disorders are still treated as entirely separate issues, leaving the essential biology of both conditions unaddressed. This causes patients to become trapped in ongoing cycles of relapse. In reality, there are multiple factors that continually work together and worsen patient quality of life and outcomes, including the neglected orexin-driven arousal mechanisms, abnormalities in REM sleep structure and architecture, the low use of validated screening tools, and the incomplete differential diagnoses for hypersomnia. Our symposium will help improve clinicians’ understanding of the biological link between sleep regulation and mood dysregulation, better known as the orexin system, to support a shift from fragmented, symptom-based management to integrated, mechanism-driven care.

Learning Objective 1: Understand the orexin-mediated mechanisms of arousal, REM regulation, and reward, and how these pathways influence co-occurring sleep disturbances and psychiatric disorders

Learning Objective 2: Evaluate the clinical trial data surrounding safety, efficacy, and adverse event monitoring of new and emerging orexin receptor antagonists

References

Vasudeva S, Wong S, Le GH, Dri CE, Teopiz KM, Ho R, Rhee TG, McIntyre RS. Efficacy and safety profiles of FDA-approved dual orexin receptor antagonists in depression: A systematic review of pre-clinical and clinical studies. J Psychiatr Res. 2025 Nov;191:752-769. doi: 10.1016/j.jpsychires.2025.10.001. Epub 2025 Oct 10. PMID: 41109037. Holguin G, Martin-Fardon R. Modulatory effects of orexin and dynorphin on stress-related alcohol seeking and relapse: pivotal role of the posterior paraventricular nucleus of the thalamus. Front Pharmacol. 2026 Jan 26;17:1729040. doi: 10.3389/fphar.2026.1729040. PMID: 41669681; PMCID: PMC12883789. 6:30 a.m. - 8:00 a.m. Satellite Symposium: Incorporating Novel Muscarinic Agents for Schizophrenia Into Clinical Practice: Overcoming Clinical Inertia