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New pharmacologic agents for insomnia and hypersomnia
David C Earl1, Kendall M Van Tyle2
1Division of Pulmonary, Critical Care, and Sleep Medicine, Sleep Disorders Center, University of New Mexico School of Medicine, Albuquerque, New Mexico.
Current Opinion in Pulmonary Medicine
|September 5, 2020
Summary
Recent advancements offer new treatments for insomnia and hypersomnia, including novel medications and dosage forms. Healthcare providers should discuss potential risks like complex sleep behaviors and driving impairment with patients.
Area of Science:
- Sleep medicine
- Pharmacology
Background:
- Insomnia and hypersomnia are complex conditions with multifactorial origins.
- Treatment advancements are crucial for managing these sleep disorders.
Purpose of the Study:
- To review recent developments in the treatment of insomnia and hypersomnia.
- To highlight novel therapeutic agents and updated treatment guidelines.
Main Methods:
- Literature review of recent clinical trials and regulatory updates.
- Analysis of new drug approvals and dosage formulations for sleep disorders.
Main Results:
- Benzodiazepine receptor agonists now carry warnings for complex sleep behaviors.
- New formulations of zolpidem are available.
- Orexin receptor antagonists show a good safety profile, with suvorexant approved for comorbid insomnia and dementia.
- Lemborexant is effective for maintenance insomnia.
- Trazodone may have implications for dementia pathology.
- Pitolisant and solriamfetol offer new treatment options for hypersomnia, with specific indications and warnings.
Conclusions:
- Novel agents and new dosage forms are transforming insomnia treatment.
- Orexin receptor antagonists require discussion of complex sleep behaviors and driving impairment risks.
- Emerging treatments for hypersomnia provide alternatives to traditional stimulants.
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