Patients with insomnia experience impairment in daytime functioning, which can impact quality of life, mood, and memory, as well as result in fatigue and work/educational impairment. Dual orexin receptor antagonists have demonstrated efficacy in treating insomnia. Daridorexant is a new type of orexin receptor antagonist; orexins are wake-promoting neuropeptides (i.e., hypocretins) that are hypothesized to dampen overactive wakefulness without resulting in sedation.
Results of two randomized-controlled, phase 3 trials, which were published in the Lancet Neurology, showed that daridorexant 25 mg and 50 mg improved sleep outcomes in insomnia patients. Furthermore, daridorexant 50 mg enhanced daytime functioning. Daridorexant improves both objective and subjective measures of sleep. Notably, the intervention was safe, with adverse events including headache and somnolence/fatigue.
Discussion questions: Which of your patients do you think are well-suited to try daridorexant? How would you monitor treatment and evaluate improvements in daytime functioning?
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Sleep Disorder Connect4yrHow would you dose your patients? What do you take into consideration? -
Frank Abenante4yrpatients who have difficulty in falling asleep and staying asleep. I would monitor by patient evaluation and physical exam.