Evidence map›Paper›PMID 31538599›Full record

Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2019

Can the Orexin Antagonist Suvorexant Preserve the Ability to Awaken to Auditory Stimuli While Improving Sleep?

Christopher L Drake, David A Kalmbach, Philip Cheng, Thomas Roth, Kieulinh Michelle Tran, Andrea Cuamatzi-Castelan, Rachel Atkinson, Meeta Singh, Christine V Tonnu, Cynthia Fellman-Couture

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03312517 (A Phase IV 3-Way Double-blind, Randomized, Crossover Study to Compare the Awakening Threshold Effects), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03312517 phase4completednot on this map

A Phase IV 3-Way Double-blind, Randomized, Crossover Study to Compare the Awakening Threshold Effects (Responsivity) of Belsomra 10 mg and 20 mg to Placebo in Non-elderly Insomniacs

TypeinterventionalSponsorHenry Ford Health SystemRan2018 to 2018Enrolled12ConditionsInsomniaArmsSuvorexant 10 mg, Suvorexant 20 mg, Placebo oral capsule
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Christopher L DrakeThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
David A KalmbachThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Philip ChengThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Thomas RothThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Kieulinh Michelle TranThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Andrea Cuamatzi-CastelanThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Rachel AtkinsonThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Meeta SinghThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Christine V TonnuThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Cynthia Fellman-CoutureThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan.
Henry Ford Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesThe safety profile of the dual orexin receptor antagonists (DORAs) are currently unknown with regard to nocturnal responsivity among people with insomnia. We compared the auditory awakening thresholds (AATs) of the DORA suvorexant (10 and 20 mg) versus placebo in 12 individuals with DSM-5 insomnia.

methodsThe study used a double-blind, placebo-controlled, three-way crossover design. Participants were randomly assigned to a treatment sequence that included placebo, suvorexant 10 mg, and suvorexant 20 mg. At the time of maximum drug concentration, auditory tones were played during stable stage N2 sleep. Tones increased by 5-decibel (db) increments until the participant awakened. The db at awakening was recorded as the AAT and compared between conditions. The proportion of awakenings higher than 85 db was also compared between conditions. Finally, sensitivity analyses were also conducted using surrounding thresholds (80 db and 90 db).

resultsThe mean AAT did not differ significantly between either dose of suvorexant compared to placebo. Moreover, the proportions of individuals who remained asleep at the AAT 85 db cutoff did not differ across conditions. In addition, wake after sleep onset decreased and total sleep time increased in the suvorexant 20 mg condition compared to placebo.

conclusionsSuvorexant (10 and 20 mg) preserved the ability to respond to nocturnal stimuli, whereas the 20-mg dose improved the sleep of people with insomnia. This suggests that DORAs such as suvorexant can effectively treat insomnia while allowing patients to awaken to nocturnal stimuli in the environment. CLINICAL

trial registrationRegistry: ClinicalTrials.gov; Title: A Phase IV 3-Way Double-blind, Randomized, Crossover Study to Compare the Awakening Threshold Effects (Responsivity) of Belsomra 10 mg and 20 mg to Placebo in Non-elderly Insomniacs; Identifier NCT03312517; URL: https://clinicaltrials.gov/ct2/show/NCT03312517. CITATION: Drake CL, Kalmbach DA, Cheng P, Roth T, Tran KM, Cuamatzi-Castelan A, Atkinson R, SinghM, Tonnu CV, Fellman-Couture C. Can the orexin antagonist suvorexant preserve the ability to awaken to auditory stimuli while improving sleep? J Clin Sleep Med. 2019;15(9):1285-1291.

Indexed as

Acoustic StimulationAdultAzepinesCross-Over StudiesDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansMaleMiddle AgedOrexin Receptor AntagonistsPolysomnographySleep Initiation and Maintenance DisordersTriazolesWakefulnessYoung AdultAzepinesOrexin Receptor AntagonistssuvorexantTriazoles

Identifiers

PMID31538599
PMCPMC6760418
OpenAlexW2972655045

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.