GABA neurons in the sublaterodorsal tegmental nucleus suppress wakefulness in healthy and narcoleptic mice.

The sleep-wake cycle is generated by competing neural circuits that control the oscillation between wakefulness, rapid eye movement (REM) sleep, and non-REM (NREM) sleep. While the sublaterodorsal tegmental nucleus (SLD) is recognized for its role in REM sleep generation, the functional contribution of its GABAergic neurons (SLDGABA) to sleep-wake regulation remains poorly understood. Here, we found that SLDGABA neurons function as a suppressor of wakefulness in both healthy (i.e., orexin+/+) and narcoleptic (i.e., orexin-/-) mice. In healthy mice, optogenetic silencing of SLDGABA neurons rapidly induced robust wakefulness, while enhancing cortical and motor activity. Conversely, optogenetic activation of these neurons suppressed wakefulness and promoted NREM sleep. We found traces of SLDGABA axonal projections to wake-promoting brain regions, providing an anatomical basis for their wake-suppressing effects. Importantly, we discovered that SLDGABA neurons play a pathological role in narcolepsy: their activation in orexin-deficient narcoleptic mice triggered characteristic sleep attacks-rapid intrusions of NREM sleep during active wakefulness-while silencing these neurons rescued animals from both sleep attacks and cataplexy. Collectively, these findings establish SLDGABA neurons as a key regulator of arousal state transitions and identify them as a novel therapeutic target for the treatment of narcolepsy.