From the Research
I recommend using ramelteon as a hypnotic with midofinil, as it has been shown to be efficacious in improving sleep parameters with a relatively safe profile, according to the most recent and highest quality study available 1. When considering the use of hypnotics with midofinil, it's essential to prioritize the safety and efficacy of the combination. Midofinil, a wakefulness-promoting agent, can interfere with sleep quality, and combining it with hypnotics may lead to unpredictable results. However, if sleep difficulties persist, ramelteon, a melatonin receptor agonist, may be a suitable option.
- Ramelteon has been shown to improve sleep onset latency, total sleep time, and sleep efficiency in patients with insomnia, with a relatively low risk of adverse effects 1.
- The most recent study available, a systematic review and meta-analysis published in 2023, found that ramelteon has a large effect size on objective total sleep time and subjective total sleep time, as well as sleep onset latency, making it a viable option for patients with insomnia 1.
- In contrast to other hypnotics, ramelteon has a lower risk of dependence, abuse, and withdrawal symptoms, making it a safer choice for long-term use 2, 3.
- While other studies have investigated the efficacy and safety of ramelteon, the 2023 study provides the most up-to-date and comprehensive evidence, making it the primary basis for this recommendation 1.