The purpose of this study is to evaluate a medication called clarithromycin for treating sleepiness in narcolepsy and idiopathic hypersomnia. Studies have shown that clarithromycin can reduce sleepiness, but researchers do not know how clarithromycin does this. This study will look at brain activity (on magnetic resonance imaging \[MRI\]), inflammation, bacteria living in the gut, and cerebrospinal fluid, to better understand how clarithromycin can reduce sleepiness. This study will recruit 92 participants who will be randomized to receive clarithromycin or a placebo for 14 days.
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Change in Epworth Sleepiness Scale Score
Timeframe: Day -1, Day 14
Change in Maintenance of Wakefulness Test (MWT)
Timeframe: Day -1, Day 14
Change in gamma-aminobutyric acid receptor A (GABA-A) potentiation
Timeframe: Day -1, Day 14
Change in Default Mode Network (DMN) Connectivity
Timeframe: Day -2, Day 13
Change in tumor necrosis factor - alpha (TNF-α)
Timeframe: Day -1, Day 14
Change in gastrointestinal microbiome composition
Timeframe: Day -1, Day 14