Das Orexinsystem als neuer Ansatz zur Besserung von Schlaf und Tagesaktivität – eine innovative Therapieoption zur Behandlung der chronischen Insomnie

Chronic insomnia is one of the most common sleep disorders. Its pharmacological therapy is limited to a few approved hypnotics.

The dual orexin receptor blocker daridorexant is a novel sleep-promoting drug in terms of mechanism of action and effects that has demonstrated efficacy in clinical trials with people affected by moderate to severe insomnia. Both in the overall population and in those over 65 years of age, daridorexant objectively decreased the latency to falling sleep and the time spent wake during sleep and increased the subjective duration of sleep. The latter is particularly pronounced in older insomnia patients. Additionally relevant to sleep-deprived patients is the positive effect of daridorexant on daytime functioning, which was demonstrated by a questionnaire on sleepiness, alertness, cognition, and mood. Improvements were also shown in analog scales on sleep. Tolerability was very good during the 3‑month study period, and there were no signs of the development of tolerance or dependence.

Owing to the improvement of sleep and daytime functioning, as well as the favorable side effects profile, daridorexant is recommended as an innovative hypnotic that enriches the differential therapy of chronic insomnia.