The effect of lemborexant on insomnia in patients with psychiatric disorders: detailed evaluation using the Athens Insomnia Scale

Abstract

Abstract Chronic insomnia is common and associated with reduced quality of life. Benzodiazepine hypnotics are commonly prescribed for insomnia, but have potential side effects including concentration impairment, somnolence, and dependence. Lemborexant is an orexin receptor antagonist considered to have fewer side effects. The objectives of this study were to evaluate in detail the effects of lemborexant and examine whether the addition of lemborexant could gradually taper off benzodiazepine hypnotics. We retrospectively examined the effectiveness of lemborexant in 28 outpatients with insomnia. Insomnia symptoms were assessed using the Athens Insomnia Scale before and after lemborexant administration. We also attempted to taper and assessed doses of benzodiazepine hypnotics using diazepam equivalents for some patients taking benzodiazepine hypnotics. The mean Athens Insomnia Scale score was significantly improved after lemborexant treatment (8.7 ± 5.2 vs. 3.8 ± 3.3; p < 0.01). Among the Athens Insomnia Scale sub-items, significant improvement was observed for six items: sleep induction, awakenings during the night, total sleep duration, sleep quality, well-being, functioning capacity, and sleepiness during the day. The mean benzodiazepine dose was significantly lower after lemborexant treatment (4.6 ± 5.0 mg vs. 2.1 ± 3.3 mg; p < 0.01). This study indicated the potential of lemborexant for improving insomnia and reducing benzodiazepine dose.