What Makes Orexin-Blocking Sleep Agents Special?

Belsomra (suvorexant) entered the US sleep-aid market almost a decade ago, and was recently joined by Dayvigo (lemborexant) and Quviviq (daridorexant). All of these agents work to block orexin receptors in the brain, a distinctively different mechanism than other sleeping pills. Despite several distinct advantages over other classes of sleeping agents, sales have not been spectacular. But recent discoveries, particularly a suggestion that suvorexant may reduce the amyloid Beta plaques and Tau fibrillary tangles that are hallmarks of Alzheimer's Dementia has driven up attention. Experts think that these agents may also have a role in treating depression, anxiety and ADHD.

[plunker]

Took my 1st 5mg dose of dayvigo tonight and falling asleep watching your video thankyou!

[ivandansigmun]

Daridorexant has been a life saver. Better sleep quality with more energy the next day. I do dream a lot whilst sleeping now.

[JoAnnaSettlemyer-me]

My doctor prescribed Belsomra for sleep - it works well as long as I take it three hours after eating - need an empty stomach for it to work - works well - thanks for the info!

[jasdeep]

Well executed talk. Interesting and relevant. Really helped me gain a primer on the DORA class of drugs. In my opinion I would change not much…it’s much harder to be engaging and teach without the assistance of dreaded PowerPoints so kudos to you Dr Kruse. Thank you!

[Dustin_-]

Thank you for making this succinct video

[XenoTravis]

I wouldn't say belsomra is special, just unique since it was one of the first attempts at the theory.
It is a failure and never showed much potential. Especially when the FDA only approved it and more than half the dose of the dose used in research. Including the creators, nobody had hopes in it.

Hopefully something else comes out that 1- induces HEALTHY sleep 2 - doesn't create a quick tolerance 3 - doesn't cause a high or sleep walk behaviors 4 - causes a restful feeling after waking from a full night's sleep.

[thomaslau]

It does not work on me. The first night taking 5mg, it leads to vivid dream in the middle of the night. The second night, no sleep was induced two hours after taking Dayvigo. So upset.

[DrunknMonky]

Would this type of med be good for ADHD related insomnia. I’ve had a sleep disorder for over 20 years due to my adhd. It’s absolutely wrecked my life

[geoff_onYT]

For someone with over 10 years of onset insomnia AND who is exhausted/non-functional at daytime. Does this mean that modafinil + a DORA could be a very logical & rational combination? because they won't on the same system in opposite directions
one would take modafinil in the early morning to survive the day, and take the DORA at night to block the effects of the modafinil that is lingering in the body?
It'd be essential to take both, because modafinil has such an extremely long half-life?

obviously I've tried everything else (e.g. CBT-i, stimulus control, sleep restriction therapy, blue light control, melatonin, etc.)

[FeelFreeToThink]

Too long. Make it shorter and you'll increase viewership 10x