Murayama Tomonori, Ito Yuji, Narita Kenji, Ishida Tetsuro, Hinotsu Shiro, Fujita Masahiko
Department of Psychiatry Asahikawa Keisenkai Hospital Hokkaido Japan.
Department of Psychiatry Kushiro Red Cross Hospital Hokkaido Japan.
PCN Rep. 2024 Jan 21;3(1):e165. doi: 10.1002/pcn5.165. eCollection 2024 Mar.
Chronic insomnia disorder is common and associated with reduced quality of life. Benzodiazepine hypnotics are commonly prescribed for insomnia, but have potential side effects such as concentration impairment, somnolence, and dependence. Lemborexant (LEM) is an orexin receptor antagonist considered to have fewer side effects than benzodiazepine hypnotics. This study evaluated the effect of LEM on sleep in detail and examined whether benzodiazepine hypnotics can be gradually tapered by adding LEM.
We retrospectively examined the effectiveness of LEM in 28 outpatients with insomnia. Insomnia symptoms were assessed using the Athens Insomnia Scale (AIS) before and after LEM administration. We also attempted to taper benzodiazepine hypnotics and assessed benzodiazepine dose using diazepam equivalents for some patients taking benzodiazepine hypnotics. Wilcoxon's signed-rank test was used for statistical analysis.
The mean AIS score was significantly improved after LEM treatment (8.7 ± 5.2 vs. 3.8 ± 3.3; P < 0.01). Among the AIS subitems, significant improvement was observed for six items: sleep induction, awakenings during the night, sleep quality, well-being, functioning capacity, and sleepiness during the day. The mean benzodiazepine dose was significantly lower after LEM treatment (4.6 ± 5.0 mg vs. 2.1 ± 3.3 mg; P < 0.01).
This study indicated the potential of LEM for improving insomnia and reducing benzodiazepine dose.
慢性失眠障碍很常见，且与生活质量下降相关。苯二氮䓬类催眠药常用于治疗失眠，但有注意力不集中、嗜睡和依赖等潜在副作用。伦博瑞生（LEM）是一种食欲素受体拮抗剂，被认为比苯二氮䓬类催眠药副作用更少。本研究详细评估了LEM对睡眠的影响，并探讨了加用LEM后是否可逐渐减少苯二氮䓬类催眠药的用量。
我们回顾性分析了28例失眠门诊患者使用LEM的有效性。在使用LEM前后，采用雅典失眠量表（AIS）评估失眠症状。我们还尝试减少苯二氮䓬类催眠药的用量，并对部分服用苯二氮䓬类催眠药的患者使用地西泮等效剂量评估苯二氮䓬类药物剂量。采用Wilcoxon符号秩检验进行统计分析。
LEM治疗后AIS平均得分显著改善（8.7±5.2 vs. 3.8±3.3；P<0.01）。在AIS子项目中，有6项显著改善：入睡、夜间觉醒、睡眠质量、幸福感、功能能力和白天嗜睡。LEM治疗后苯二氮䓬类药物平均剂量显著降低（4.6±5.0mg vs. 2.1±3.3mg；P<0.01）。
本研究表明LEM在改善失眠和减少苯二氮䓬类药物剂量方面具有潜力。
