While breakthroughs in our understanding of narcolepsy type 1 (NT1) have led to novel approaches, NT1 can be a challenge to diagnose and manage, leading to delays and unmet needs for patients with this debilitating disease. In this symposium, we'll explore the evolving science behind orexin (hypocretin) deficiency, dissect the current diagnostic tools that allow us to catch narcolepsy earlier and more accurately, and take a closer look at targeted orexin-based therapies on the horizon and the latest approaches to management.