Background: Narcolepsy type 1 (NT1) is a chronic neurologic disorder defined by excessive daytime
sleepiness, cataplexy, sleep paralysis, hallucinations and disrupted nocturnal sleep, typically with onset during childhood/
adolescence. Pediatric NT1 is associated with limitations on children’s activities and achievements, especially
poor performance at school, difficulty with peers due to disease symptoms and comorbidities including depression,
obesity, and precocious puberty. Sodium oxybate (SO) is a sodium salt of γ-hydroxybutyric (GHB) acid and is
greatly effective in treating cataplexy and excessive daytime sleepiness in NT1 and it can be helpful also for sleep
disruption, hypnagogic hallucination and sleep paralysis in these patients.
Method: We conducted a research of literature into bibliographic databases regarding NT1 features in childhood and
the possible option treatment with SO in this kind of patient population.
Results: We reported sixteen papers focusing on symptom presentation and on clinical and metabolic features of
children affected with NT1. Furthermore, we reported 24 manuscripts focusing on SO biological actions and pharmacological
properties and on the few but important available studies (8) conducted in NT1 children under SO therapy.
Conclusion: Although in the majority of patients develop NT1 during childhood, there are no approved treatments
for pediatric NT1. However, SO has been widely used off-label to treat narcolepsy symptoms in children and adolescents
with NT1 in non-controlled studies, showing a similar safety profile and therapeutic response to adult patients.
Ongoing pediatric therapy is based only on observational data shared among sleep disorders clinicians.