There is no biological measure for wakefulness. In a narcolepsy clinical trial, a patient lies down in a dark lab while clinicians count the minutes until sleep comes. The average time in four tests counts as the result. Sarah Sheikh, head of the neuroscience therapeutic area unit and head of global development at Takeda Pharmaceutical, says this maintenance of wakefulness test is perhaps the most boring and artificial of all clinical tests, but it is the standard way of evaluating narcolepsy drugs.

A Takeda drug that could be first in a new class of narcolepsy medicines met the main goal of two Phase 3 clinical trials with statistically significant results showing it helped participants stay awake longer in those darkened rooms. But here’s what it meant for patients in their daily lives:

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