Mink Schinkelshoek, MD, PhD, Leiden University Medical Center, Leiden, Netherlands, discusses exciting developments in the field of narcolepsy. The immune hypothesis is both an interesting and important aspect of narcolepsy, which could lead to the development of alternative treatment options which address the cause, rather than the symptoms, of the chronic sleep disorder. However, treating symptoms is also very important for patients. In the next ten years, there will be great developments in orexin receptor agonists. Dr Schinkelshoek states that this will drastically change the capabilities of treatment in narcolepsy; orexin receptor agonists can mimic the mechanisms of hypocretin, allowing individuals to stay awake during the day and asleep at night. This will be the most important development in the coming years as orexin agonists have the capability to treat all the symptoms of narcolepsy – not requiring polypharmacy to treat them individually. This interview took place at the World Sleep Congress 2022 in Rome, Italy.