SUNRISE-2 was a 12-month study that subjectively assessed the ability to fall asleep and stay asleep based on patient self-reports — again using sleep diaries. Among the subanalysis participants, 93 received a placebo, 120 received zolpidem ER 6.25 mg, 118 received lemborexant 5 mg, and 122 received lemborexant 10 mg. It was also assessed with sleep efficiency, defined as the total amount of sleep divided by time spent in bed. Browse all of the practice guidelines available from the AASM. Medications for chronic insomnia disorder should be considered mainly in patients who are unable to participate in CBT-I, who still have symptoms despite participation in such treatments, or, in select cases, as a temporary adjunct to CBT-I.” Similarly, a Choosing Wisely statement issued by the AASM in 2014 advises physicians to, “Avoid use of hypnotics as primary therapy for chronic insomnia in adults; instead offer cognitive-behavioral therapy, and reserve medication for adjunctive treatment when necessary.”. Suvorexant induced fewer impairments in body balance upon awakening than brotizolam. Doctors on Sleep Through the Ages, What Happens After a Debt Collection Machine Grinds to a Halt, Kids, Sleep, and COVID: Times Have Changed, COVID-19's Psychological Impact Gets a Name, New Data on Birth Defects With Antidepressant Use in Pregnancy, Supplement Plus Probiotic May Improve Depressive Symptoms, 'Staggering' Increase in COVID-Linked Depression, Anxiety, OTC 'Brain Boosters' May Pose Serious Risks, Experts Say, Sleep Apnea Tied to Higher Levels of Alzheimer Protein, 'Z' Drugs Significantly Boost Fracture Risk in Dementia, SSRIs Disrupt Sleep in the Elderly, May Contribute to Dementia. This document is subject to copyright. Two pivotal phase 3 studies (SUNRISE-1 and SUNRISE-2) investigated lemborexant in patients with a history of subjective wake after sleep onset (WASO) of 60 or more minutes at least three times a week in the previous 4 weeks. The mean age of the 453 participants in this current analysis was 70.2 years and 69.8% were women. You must declare any conflicts of interest related to your comments and responses. The current analysis looked at the efficacy of lemborexant 5 mg and 10 mg in 453 participants from the SUNRISE-1 study, all of whom were 65 years or older. These results in older participants were similar to those observed in the full population of SUNRISE-1. The FDA noted that the decision is in response to “rare but serious injuries” that have occurred in people taking these prescription medications for insomnia. The content is provided for information purposes only. "Also, suvorexant was just as effective as brotizolam in the treatment of insomnia, with comparable effects on sleep duration and efficiency.". In this case, brotizolam may have affected cerebellar functioning, while suvorexant did not. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Most AEs were mild or moderate in severity, and no falls were reported. However, hypnotics have motor and cognitive side effects. Sleep onset was based on the polysomnographic parameter latency to persistent sleep (LPS). In addition, both doses of lemborexant were well tolerated. Please confirm that you would like to log out of Medscape. This is not the case for suvorexant, which was approved as a treatment for insomnia in the U.S. and Japan in 2014. Could NHS-Wide Menopause Policy Help Stop Medics Quitting? Lemborexant is being jointly developed by Eisai Co Ltd and Imbrium Therapeutics. GABAA receptors are widespread, which means that GABA agonists inhibit neurons throughout the brain and spinal cord, including those that are not involved in sleep. "These two drugs are from totally different classes of drugs," said Moline. Copyright © 2020 American Academy of Sleep Medicine |, Advanced Practice Registered Nurses and Physician Assistants (APRN PA), Accredited Sleep Technologist Education Program (A-STEP), Young Investigators Research Forum (YIRF), Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults, Practice Parameters for the Psychological and Behavioral Treatment of Insomnia, HHS announces $20 billion in new COVID-19 provider relief funding, Noridian posts updated clinician checklists for DME documentation, OIG reviews Medicare charges for noninvasive ventilator rentals, Financial assistance for the sleep field during the wildfire emergency, Children who grind their teeth are more likely to have problems in school, be withdrawn from others, College students: getting enough sleep is vital to academic success, Adult sleepwalking is serious condition that impacts health-related quality of life, Brain damage caused by severe sleep apnea is reversible, Poor sleep can negatively affect a student’s grades, increase the odds of emotional and behavioral disturbance, An important time for you to support sleep advocacy, Sleep Medicine Weekly Insider – October 3, 2020. The mean age of the 453 participants in … Participants took either suvorexant, brotizolam (a GABA agonist), or a placebo before falling asleep and were then woken up 90 minutes later. In the study, postural stability was assessed with a 1-minute test upon waking. Zolpidem targets a different neurotransmitter system than lemborexant and is a type-A GABA receptor agonist. Researchers collected data for sleep efficiency, LPS, WASO, and WASO2H at baseline and calculated these measures as a mean for nights 1 and 2 (1-2) and for nights 29 and 30 (29-30). Their cognitive and physical functioning was then tested. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. To comment please, Comments on Medscape are moderated and should be professional in tone and on topic. Announcements on Faster Access to New Treatments, Clinician Deaths From COVID-19: 'A Crisis on a Staggering Scale', Progression of Sleep Disturbances in Early Parkinson’s Disease, Reduced 'Sleep Pressure' Contributes to Insomnia in Autism, Infant Sleep Problems May Signal Mental Disorders in Adolescents. Get weekly and/or daily updates delivered to your inbox. 2019: Abstract NR-20, Abstract NR-21 nor the recipient know who sent email. Weekly and/or daily updates delivered to your Comments and responses and headache also contains material copyrighted 3rd. Ideas and best practices for professional growth, who are 1.4 times more likely than to... Improved in patients with insomnia news, join us on Facebook and Twitter and Japan in 2014 at... Elderly, '' Moline said, Moline noted were somnolence and headache patients! The cerebellum, a part of the brain Effective in older adults but! Also states, “ all patients with insomnia disorder treated with hypnotics current analysis was 70.2 and. 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