Yasuda Kazuya, Hirano Yoji, Takeda Ryuichiro, Ikeda Ryuji, Ishida Yasushi
Department of Pharmacy, University of Miyazaki Hospital, Miyazaki, Japan.
Division of Clinical Neuroscience, Department of Psychiatry, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Neuropsychopharmacol Rep. 2025 Mar;45(1):e12506. doi: 10.1002/npr2.12506. Epub 2024 Nov 29.
Suvorexant is an orexin receptor antagonist (ORA) for the treatment of insomnia. The antagonistic action of suvorexant on orexin receptors is associated with an increase in rapid eye movement (REM) sleep, which can potentially lead to nightmares depending on the patient's condition. However, the precise risk factors for nightmares among patients taking ORAs, such as suvorexant, have yet to be identified. In this retrospective study, we aimed to identify the risk factors for the development of nightmares in patients treated with suvorexant.
The risk factors were determined by comparing parameters between the nightmare group and the nonnightmare group. This study included 440 patients who received suvorexant at the University of Miyazaki Hospital from April 2014 to January 2021.
We found that 9.1% (n = 40) of the patients experienced suvorexant-induced nightmares. There was a significant difference in the median age, which was lower in the nightmare group than in the nonnightmare group (p < 0.01). Furthermore, both multiple logistic regression analysis and Cox proportional hazards regression analysis revealed increased odds ratios for nightmares for individuals aged 20-39 years.
This study revealed that elderly patients taking suvorexant had fewer nightmares than nonelderly patients did.
苏沃雷生是一种用于治疗失眠的食欲素受体拮抗剂（ORA）。苏沃雷生对食欲素受体的拮抗作用与快速眼动（REM）睡眠增加有关，这可能会根据患者的情况导致噩梦。然而，服用ORA（如苏沃雷生）的患者中噩梦的确切风险因素尚未确定。在这项回顾性研究中，我们旨在确定接受苏沃雷生治疗的患者发生噩梦的风险因素。
通过比较噩梦组和非噩梦组之间的参数来确定风险因素。本研究纳入了2014年4月至2021年1月在宫崎大学医院接受苏沃雷生治疗的440例患者。
我们发现9.1%（n = 40）的患者经历了苏沃雷生引起的噩梦。中位年龄存在显著差异，噩梦组低于非噩梦组（p < 0.01）。此外，多项逻辑回归分析和Cox比例风险回归分析均显示，20至39岁的个体做噩梦的优势比增加。
本研究表明，服用苏沃雷生的老年患者比非老年患者做噩梦的情况更少。
