From the Research
Dayvigo (lemborexant) can be used in a 76-year-old female, but with caution and careful consideration of potential side effects, particularly given the increased sensitivity to sleep medications in older adults, as evidenced by a 2024 study 1 that demonstrated its efficacy and safety in adults ≥65 years of age with insomnia disorder. When considering the use of Dayvigo in this patient population, it is essential to weigh the potential benefits against the risks, including dizziness, drowsiness the next day, risk of falls, and potential cognitive impairment.
- The recommended starting dose for elderly patients is 5 mg taken once nightly immediately before bedtime, which is lower than the standard adult dose.
- Before starting Dayvigo, the patient should discuss with her doctor all current medications to check for interactions, especially other CNS depressants.
- Non-drug approaches to insomnia, such as good sleep hygiene, regular sleep schedule, avoiding caffeine and alcohol near bedtime, and cognitive behavioral therapy for insomnia, should be tried first, as supported by studies 2, 3, 4.
- Dayvigo works by blocking orexin receptors in the brain, which helps regulate the sleep-wake cycle, and its use should be regularly reassessed by her physician to determine if continued use is appropriate, with consideration of its efficacy and safety profile as described in 1, 5.