Narcolepsy is caused by a loss of orexin/hypocretin signaling, resulting in chronic sleepiness, fragmented non-rapid eye movement sleep, and cataplexy. To identify the neuronal circuits underlying narcolepsy, we produced a mouse model in which a loxP-flanked gene cassette disrupts production of the orexin receptor type 2 (OX2R; also known as HCRTR2), but normal OX2R expression can be restored by Cre recombinase. Mice lacking OX2R signaling had poor maintenance of wakefulness indicative of sleepiness and fragmented sleep and lacked any electrophysiological response to orexin-A in the wake-promoting neurons of the tuberomammillary nucleus. These defects were completely recovered by crossing them with mice that express Cre in the female germline, thus globally deleting the transcription-disrupter cassette. Then, by using an adeno-associated viral vector coding for Cre recombinase, we found that focal restoration of OX2R in neurons of the tuberomammillary nucleus and adjacent parts of the posterior hypothalamus completely rescued the sleepiness of these mice, but their fragmented sleep was unimproved. These observations demonstrate that the tuberomammillary region plays an essential role in the wakepromoting effects of orexins, but orexins must stabilize sleep through other targets.arcolepsy is caused by a selective loss of the hypothalamic neurons producing the orexin (i.e., hypocretin) neuropeptides and is one of the most common causes of chronic sleepiness (1). In humans and mice, loss of orexin signaling results in unstable sleep/wake states, with poor maintenance of wakefulness, fragmented sleep, and intrusions into wakefulness of elements of rapid eye movement (REM) sleep, including brief episodes of paralysis known as cataplexy. The orexin neuropeptides strongly excite many brain regions that regulate sleep/wake behavior, yet the key pathways through which orexins stabilize wakefulness and sleep remain unknown.Orexins act through two receptors, OX1R and OX2R (also known as HCRTR1 and HCRTR2), and the OX2R seems to play a critical role in the maintenance of wakefulness. Mice constitutively lacking OX2R are unable to maintain long bouts of wakefulness and can fall asleep rapidly (2). In addition, an OX2R antagonist strongly promotes sleep, whereas an OX1R antagonist has no effect (3).Although it is clear that OX2R signaling is necessary for the normal maintenance of wakefulness, the anatomic sites through which this occurs remain unknown. OX2R is expressed in many wake-promoting brain regions, including the histaminergic neurons of the tuberomammillary nucleus (TMN), other monoaminergic regions, cholinergic systems, and forebrain regions, including the thalamus and cortex (4). Several researchers have hypothesized that the TMN is a key site because orexin-A excites the TMN neurons and infusion of orexin-A near this region promotes wakefulness (5-7). However, this perspective is controversial as optogenetic activation of the orexin neurons promotes arousal in mice lacking histamine (8), and mice lacking both OX1...