Related Experiment Video

Updated: Aug 12, 2025

Polygraphic Recording Procedure for Measuring Sleep in Mice
08:45

Polygraphic Recording Procedure for Measuring Sleep in Mice

Published on: January 25, 2016

23.9K

Orexin dual receptor antagonists, zolpidem, zopiclone, eszopiclone, and cognitive research: A comprehensive

Mengzhen Zhou1, Jiyou Tang1, Shasha Li1

  • 1Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.

Frontiers in Human Neuroscience
|January 26, 2023
PubMed
Abstract

Insights

Orexin dual receptor antagonists (DORA) effectively treat insomnia without cognitive impairment. Zolpidem aids sleep but carries risks; eszopiclone and zopiclone require further safety evaluation for cognitive effects.

Area of Science:

  • Pharmacology
  • Sleep Medicine
  • Cognitive Neuroscience

Background:

  • Insomnia affects one-third of adults, with chronic use of hypnotics potentially leading to cognitive deficits.
  • Understanding the cognitive impact of various insomnia medications is crucial for patient safety and treatment efficacy.

Purpose of the Study:

  • To evaluate the cognitive effects of different doses of orexin dual receptor antagonists (DORA), zopiclone, eszopiclone, and zolpidem.
  • To compare the efficacy and safety profiles of these insomnia treatments regarding cognitive function.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted using data from PubMed, Embase, Scopus, Cochrane Library, and Google Scholar up to September 20, 2022.
  • Primary outcomes included cognitive function measures (memory, alertness, executive function, attention), with secondary outcomes focusing on sleep quality and adverse events.
  • Data analysis involved calculating the standard mean difference (SMD) for continuous variables using RStudio.

Main Results:

  • Orexin dual receptor antagonists (DORA) showed significant improvements in Digit Symbol Substitution Test (DSST) scores across low, medium, and high doses, indicating no cognitive impairment.
  • Zolpidem demonstrated negative effects on DSST scores, particularly at medium and high doses, suggesting potential cognitive impairment.
  • All evaluated medications, including DORA, zolpidem, eszopiclone, and zopiclone, demonstrated improvements in total sleep time (TST), with varying degrees of effect.

Conclusions:

  • Orexin dual receptor antagonists (DORA) are recommended as a preferred insomnia treatment due to their efficacy in sleep induction and maintenance without adverse cognitive effects.
  • Reduced use of zolpidem is advised due to potential cognitive side effects, despite its sleep-maintaining properties.
  • While eszopiclone and zopiclone improve sleep quality, their long-term safety concerning cognitive function requires further investigation.
Keywords:
DORAcognitiondose-responseinsomnianBZD

More Related Videos

Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia04:34

Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia

Published on: February 17, 2023

1.2K
Author Spotlight: Overcoming Challenges in Drosophila Sleep Measurement Using DAM System05:59

Author Spotlight: Overcoming Challenges in Drosophila Sleep Measurement Using DAM System

Published on: October 20, 2023

2.5K

Related Concept Videos

Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
216
Management of Insomnia01:19

Management of Insomnia

The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
299
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
543
Substance Use Disorders Affecting Sleep01:24

Substance Use Disorders Affecting Sleep

Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
205
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
330
Antidepressant Drugs: MAOIs and Other Agents01:23

Antidepressant Drugs: MAOIs and Other Agents

Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
294