From the Guidelines
Dayvigo (lemborexant) is recommended as a treatment for insomnia in adults, with a typical starting dose of 5 mg taken once per night, immediately before bedtime, with at least 7 hours remaining before planned awakening. The dose may be increased to 10 mg if needed, based on individual response. Dayvigo works by blocking orexin receptors in the brain, which helps regulate the sleep-wake cycle. Unlike some older sleep medications, Dayvigo is classified as a dual orexin receptor antagonist (DORA) and may have less risk of next-day impairment, though patients should still be cautious about activities requiring alertness the following morning. Some key points to consider when prescribing Dayvigo include:
- Common side effects include headache, drowsiness, and abnormal dreams.
- Patients should avoid alcohol while taking Dayvigo, as it can increase sedative effects.
- This medication should be used as part of a comprehensive approach to insomnia that includes good sleep hygiene practices.
- Dayvigo is a controlled substance (Schedule IV) due to its potential for dependence, so it should be used exactly as prescribed. Although the provided evidence does not directly mention Dayvigo, it discusses the use of suvorexant, another orexin receptor agonist, which is suggested for use in treating sleep maintenance insomnia in adults 1. However, given the context of the question and the properties of Dayvigo as a dual orexin receptor antagonist, it is reasonable to consider its use in the treatment of insomnia, prioritizing its potential benefits on morbidity, mortality, and quality of life.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Dayvigo (Lemborexant) Efficacy
- Lemborexant has been shown to be effective in treating insomnia disorder in adults, with significant improvements in sleep onset and sleep maintenance compared to placebo and zolpidem tartrate extended release 2, 3.
- A network meta-analysis found that lemborexant was ranked highest among treatments for three out of four objectively measured insomnia efficacy outcomes, with a safety profile similar to other insomnia treatments 4.
- Lemborexant has been found to be effective in both short sleep duration and normal sleep duration subtypes of insomnia disorder, although the benefits were more consistent in the short sleep duration subgroup 5.
Comparison to Other Treatments
- Lemborexant has been compared to other insomnia treatments, including zolpidem tartrate extended release, eszopiclone, and benzodiazepines, and has been found to have a favorable efficacy and safety profile 6, 4.
- A study found that lemborexant had a significantly greater increase in total sleep time compared to both placebo and zolpidem tartrate extended release, and also improved rapid eye movement sleep and latency to rapid eye movement sleep 3.