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3yr
Daytime Symptoms of Insomnia

Insomnia impairs daytime functioning, presenting as fatigue, sleepiness, cognitive impairment, and more. Traditional sleep treatments have focused on the ability to address nighttime sleep, with little data demonstrating improvements in daytime functioning. Daridorexant clinical trials were designed to include patient-reported outcomes related to daytime functioning.

In addition to nighttime efficacy endpoints to evaluate the effect of 50 mg daridorexant on sleep, a secondary efficacy endpoint was included to evaluate effect on daytime insomnia symptoms. This was measured using the Insomnia Daytime Symptoms and Impact Questionnaire (IDSIQ). IDSIQ is the first patient-reported outcome tool that was developed/validated per FDA guidelines that can measure impact on daytime symptoms related to insomnia, such as mental and physical tiredness, energy levels, and more. This diagnostic tool includes 14 items across 3 domains: sleepiness, mood, and alert/cognition.

In clinical trials, when 50 mg daridorexant was taken every night, it demonstrated statistically significant reduction in daytime sleepiness vs placebo. In addition to achieving the secondary efficacy endpoint of reduced daytime insomnia symptoms, low rates of next-day somnolence and fatigue were reported as part of the QUVIVIQ safety profile. Adverse reaction rates in those taking 50 mg daridorexant every night for 12 months were comparable with those taking placebo.

How do you evaluate whether your patient’s treatment is providing sufficient efficacy? Do you consider whether your patient is seeing improvement in their daytime insomnia symptoms?

  • 3yr
    Obviously, the presence of refreshing sleep is paramount. However, the daytime symptoms have been checked in the past when asking about "hangover" effects in the morning.
  • 3yr
    Obviously, the presence of refreshing sleep is paramount. However, the daytime symptoms have been checked in the past when asking about "hangover" effects in the morning.
  • 3yr
    I focus on effect on daytime functioning, side effects and energy levels. Question regarding sleep onset and daytime somnolence .
  • 3yr
    Patient's self reporting is most valuable in evaluation of insomnia therapy. This is easily done with comparing answers to standard sleep/insomnia question documented in previous visits. Improvement of sleep and improvement of next day fatigue and alertness equally important
  • 3yr
    evaluate whether my patient's treatment is providing sufficient efficacy by considering a number of factors, including:
    The patient's self-reported sleep quality and quantity
    The patient's ability to function during the day
    The patient's compliance with the treatment plan
    The presence of any side effects
    I also consider whether the patient is seeing improvement in their daytime insomnia symptoms. These symptoms can include:
    Fatigue
    Difficulty concentrating
    Irritability
    Mood swings
    Reduced motivation
    Increased risk of accidents
    If the patient is not seeing improvement in their daytime insomnia symptoms, I may need to adjust the treatment plan. This could involve changing the type of medication, the dosage, or the frequency of dosing. I may also need to recommend lifestyle changes, such as improving sleep hygiene or reducing stress levels.
  • 3yr
    Asking patients their length of sleep, how many times waking up, energy level during day improves. Monitor blood pressure as uncontrolled hypertension is common in sleep disorders
  • 3yr
    The sleep log is a good option. How was the insurance coverage experience?
  • 3yr
    Asking patients about their quality of sleep, if they feel rested after sleep hours, and how they feel during the day, if feeling drowsy, fatigued or affecting driving , concentration.
  • 3yr
    I usually ask my patients to complete the Pittsburgh Sleep Quality Index to assess how well they are responding to their current treatment. I obviously consider if patients are seeing improvement in their daytime insomnia symptoms because that is the ultimate goal for insomnia treatment.
  • 3yr
    Sleep is supposed to be a revitalizing and refreshing experience and one should wake up energised to take on the challenge of the day so any Insominia treatment should aim in achieving that when treating with the meds and always ask this question when reviewing the treatment of insomnia with the pts So this data on Daridorexant seems quite impressive in that persepctive !!!
  • 3yr
    I ask the patients how long they sleep, if they wake up refreshed and if they feel tired at various times of the day
  • 3yr
    I gauge efficacy primarily based on patient self report. Patients ability to fall asleep quickly and stay asleep. Often encourage use of sleep logs or watches to monitor sleep. It is important to evaluate energy, fatigue and tendency to nap during the day as secondary endpoints.
  • 3yr
    I ask my patients if they feel well rested, how many hours of sleep they got. If they have any daytime functioning issues.
  • 3yr
    i assess their ability to function during the day and also the quality of refreshness when they wake up
    just a thorough review of systems
  • 3yr
    I ask my patients to keep a brief log of approximately how many hours they slept the night before (and how much they used to sleep) and how they awoke feeling the next morning. Excluding any PRN otc meds and interactions from alcohol is also important. I ask them to make noted about how they feel during the day - do they get to the point of needing a brief nap or not - do they feel fully alert or avoid certain activities for feeling tired / not bring this info to their appointment and we discuss this together.
  • 3yr
    getting at least 6 to 7 hours of sleep every night means that pt. treatment of insomnia is effective , and patient wont experience next day somnolence or fatigue ,or lac of concentration,
  • 3yr
    In addition to assessing sleep latency, assessing day symptoms are equally important. Difficulty waking up, residual daytime sleepiness, residual daytime difficulties with executive functioning, alertness, energy levels, need for daytime naps need to be assessed. Assessing patients in office for objective evidence can be helpful. Improvement in daily activities without incurring side effects is a goal.

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