SynthesisArquivos de neuro-psiquiatria2023
Dual orexin receptor antagonists for the treatment of insomnia: systematic review and network meta-analysis.
Synthesis in Arquivos de neuro-psiquiatria, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Long-term use of dual orexin receptor antagonists for the treatment of insomnia: a systematic review and meta-analysis.Arquivos de neuro-psiquiatria · 2026Pooled it
- Interventions for Migraine and Sleep: A Systematic Review Exploring Their Bidirectional Association.European journal of neurology · 2026Pooled it
- Efficacy and safety of lemborexant vs placebo in treating adults with insomnia disorder: a systematic review and meta-analysis of 1976 patients.Naunyn-Schmiedeberg's archives of pharmacology · 2025Pooled it
- Comparative efficacy and safety of daridorexant, lemborexant, and suvorexant for insomnia: a systematic review and network meta-analysis.Translational psychiatry · 2025Pooled it
- Effectiveness of unguided digital cognitive behavioral therapy for insomnia on depressive symptoms: a systematic review and meta-analysis of randomized controlled trials.Frontiers in psychiatry · 2025Pooled it
- Cannabinol for Acute Treatment of Insomnia Disorder in a Randomized Placebo-Controlled Crossover Trial.Journal of sleep research · 2026Trial
- Sleep as a psychiatric vital sign, not just a symptom.Dusunen adam : Bakirkoy Ruh ve Sinir Hastaliklari Hastanesi yayin organi · 2026Article
- Unlocking the Power of Plant-Derived Natural Products: Therapeutic Benefits for Cognitive Health and Neuropsychiatric Symptoms in Dementia-Related Diseases.Plants (Basel, Switzerland) · 2026Review
- Single-dose pharmacokinetics, tolerability, and physiologically based pharmacokinetic modeling of Fazamorexant in Chinese patients with hepatic impairment and in healthy controls.Frontiers in pharmacology · 2026Article
- Effects of lemborexant and zolpidem on sleep electroencephalography in older adults with insomnia: a randomized trial.Sleep advances : a journal of the Sleep Research Society · 2026Article
- Efficacy and Safety Profile of Suvorexant for the Treatment of Insomnia.Current drug safety · 2026Review
- Pharmacological modulation of hyperarousal in insomnia associated with major depressive disorder: a narrative review of sedating antidepressants and orexin receptor antagonists.Frontiers in psychiatry · 2026Review
- The effect and safety of sleep interventions on suicidal thoughts and behavior - A systematic review and meta-analyses.Sleep medicine: X · 2025Review
- Pharmacological interventions for sleep disturbance ("insomnia") in patients with advanced cancer receiving specialist palliative care: a scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Obstructive Sleep Apnea Syndrome in women: gender in sleep respiratory medicine is a first step towards personalized medicine.Sleep & breathing = Schlaf & Atmung · 2025Review
- Synergistic acupuncture and neuromodulation for chronic insomnia: a structured narrative review with systematic search and future directions.Frontiers in neurology · 2025Review
- Deciphering Post-Stroke Sleep Disorders: Unveiling Neurological Mechanisms in the Realm of Brain Science.Brain sciences · 2024Review
- Comparative Analysis of the Sedative and Hypnotic Effects among Various Parts ofPharmaceuticals (Basel, Switzerland) · 2024Article
- Data mining and safety analysis of dual orexin receptor antagonists (DORAs): a real-world pharmacovigilance study based on the FAERS database.Frontiers in pharmacology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral randomized clinical trials (RCTs) have shown that dual orexin receptor antagonists (DORAs) are effective in the treatment of chronic insomnia. However, the superiority of one particular DORA over the others remains unclear.
objectiveTo perform a network meta-analysis to evaluate the efficacy of different DORAs in patients with chronic insomnia.
methodsThe Medline, Embase, and Cochrane Central databases were searched for RCTs that compared DORA with placebo in patients ≥ 18 years of age with a diagnosis of insomnia disorder. We pooled outcomes for wake time after sleep onset (WASO), latency to persistent sleep (LPS), total sleep time (TST), and adverse events (AEs).
resultsWe included 10 RCTs with 7,806 patients, 4,849 of whom received DORAs as the intervention. Overall, we found that DORAs were associated with the improvement of all analyzed efficacy outcomes. Concerning TST, an apparent dose-dependent pattern was noticed, with higher doses relating to a longer TST. Lemborexant 10mg provided the largest reduction in WASO (at month 1) in minutes (standardized mean difference [SMD] = -25.40; 95% confidence interval [95%CI] = -40.02--10.78), followed by suvorexant 20/15mg (SMD = -25.29; 95%CI = -36.42--14.15), which also appeared to provide the largest decrease in long-term WASO (SMD = -23.70; 95%CI = -35.89--11.51). The most frequent AEs were somnolence, nasopharyngitis, and headache, with rates of up to 14.8%.
conclusionOur results suggest that DORAs are associated with greater efficacy when compared with placebo in the treatment of insomnia, a complex 24-hour sleep disorder. Additionally, dosing might play an important role in the management of chronic insomnia.
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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.