SynthesisSleep2026
Treatment of chronic insomnia in elderly adults with dual orexin receptor antagonists: a systematic review and meta-analysis.
Synthesis in Sleep, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Who cites it
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesChronic insomnia is common among older adults, and its management is particularly challenging due to changes in sleep architecture, multimorbidity, and increased vulnerability to adverse drug effects. Dual orexin receptor antagonists have emerged as a novel therapeutic class with promising efficacy and tolerability profiles. However, evidence specific to older adults remains limited. Here, we performed the first systematic review and meta-analysis specifically evaluating the efficacy and safety of dual orexin receptor antagonists in elderly patients with chronic insomnia (PROSPERO CRD42024565687).
methodsRandomized controlled trials were identified from MEDLINE, Scopus, and ClinicalTrials.gov. Objective polysomnographic outcomes, including latency to persistent sleep, total sleep time, and wake after sleep onset, as well as subjective sleep measures, were analyzed, along with safety outcomes.
resultsTen studies met the inclusion criteria for the systematic review, with five studies contributing to the meta-analysis. The quantitative synthesis comprised 2235 patients in the experimental group and 1409 patients in the control group. Overall, compared with placebo dual orexin receptor antagonists reduced wake after sleep onset and latency to persistent sleep while increasing total sleep time after 1 month and 3 months of treatment. Importantly, dual orexin receptor antagonists increased subjective total sleep time. Finally, daridorexant showed a favorable safety profile, whereas lemborexant and suvorexant were associated with higher rates of treatment-emergent adverse events than placebo, without an increase in serious adverse events.
conclusionsDespite limited evidence, dual orexin receptor antagonists appear effective and generally safe for treating chronic insomnia in the elderly, supporting their role as a valuable therapeutic option.
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