Struggling to fall asleep or stay asleep through the night? Insomnia is more than just an inconvenience—it affects energy levels, mood, and overall health. While cognitive behavioral therapy (CBT) is often the recommended first-line treatment, many people turn to medications due to accessibility challenges.
SleepScriptMD is a physician-led practice that specializes in addressing complex sleep issues. One of the most promising new treatments for insomnia involves orexin receptor antagonists, a class of medications designed to regulate wakefulness rather than induce sedation. A recent study published in Actas Españolas de Psiquiatría explores how dual orexin receptor antagonists (DORAs) like daridorexant, lemborexant, and suvorexant are emerging as alternatives to traditional sleep medications [1].
This guide is for informational purposes only and not a substitute for medical advice. Any treatment—whether a supplement, medication, procedure, injection, therapy, or device—carries potential risks, especially when used in excess or by individuals with certain medical conditions or genetic predispositions. Always consult a qualified healthcare provider before starting any treatment.
What the Research Says About Orexin Antagonists
How Orexin Impacts Sleep
The orexinergic system is responsible for regulating wakefulness by stimulating the release of neurotransmitters such as dopamine, norepinephrine, and serotonin [1]. Individuals with insomnia tend to have elevated orexin levels at night, preventing them from transitioning into restful sleep.
How DORAs Work
Unlike traditional sleep medications, which act on GABA receptors to induce sedation, DORAs work by blocking orexin receptors (OX1-R and OX2-R), preventing wakefulness signals from being activated. This mechanism allows for a more natural sleep cycle with reduced risk of morning grogginess [1].
Clinical Evidence for Daridorexant
One of the most studied DORAs is daridorexant, which has been shown to:
- Improve sleep latency (time to fall asleep) and sleep maintenance (reducing night-time awakenings) in clinical trials lasting up to 12 months [1].
- Increase total sleep time by approximately 1.5 hours per night, leading to better daytime function [1].
- Have a lower risk of dependence compared to benzodiazepines or Z-drugs, making it a safer long-term option [1].
Dosing and Side Effects
- Standard dose: 50 mg/day, though lower doses (25 mg) may be used in certain populations [1].
- Common side effects: Headache, drowsiness, and fatigue [1].
- Does not cause rebound insomnia or withdrawal symptoms when discontinued [1].
- Lower potential for abuse compared to other hypnotics, but high doses may still have some addictive properties [1].
Getting the Right Sleep Treatment Through SleepScriptMD
If you’re struggling with insomnia, finding the right treatment can make all the difference. At SleepScriptMD, we provide physician-guided virtual consultations to determine if orexin receptor antagonists or other treatment options are right for you.
Complete a quick virtual intake today, and our team will evaluate whether daridorexant, lemborexant, or other solutions are the best fit for your sleep health.
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