The TNF and IL-1β-susceptible genes through which these changes are controlled have not been identified, but the above observations imply the same principles apply as the need to reduce ATP expenditure increases in urgency with more severe illness, progressing through the increased fatigue and sleep periods to the clinical signs of encephalopathy, including coma, in severe malaria, sepsis, or influenza. The gene discussed is TNF; the disease is Sepsis.