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Published on: September 20, 2018

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Clinical Manifestations

Soichiro Shimizu1, Shoya Inagawa1, Ryo Yamamoto2

  • 1Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Abstract

Insights

Lemborexant did not improve sleep quality or cognitive function in Dementia with Lewy Body (DLB) patients. However, it did not worsen cognitive function, wake after sleep onset (WASO), or REM sleep behavior disorder (RBD).

Area of Science:

  • Neurology
  • Sleep Medicine
  • Pharmacology

Background:

  • Orexin receptor antagonists are underutilized in Dementia with Lewy Body (DLB) due to concerns about nightmares and REM sleep behavior disorder (RBD).
  • Investigating the safety and efficacy of Lemborexant, an orexin receptor antagonist, in DLB patients is crucial for clinical practice.

Purpose of the Study:

  • To evaluate the effects of Lemborexant on sleep profiles and cognitive function in patients with DLB.
  • To determine if Lemborexant exacerbates nightmares, RBD, or cognitive decline in DLB.

Main Methods:

  • 13 probable DLB patients received Lemborexant (5mg) for insomnia.
  • Actigraphy was used to assess sleep variables (TST, sleep efficiency, WASO, awakenings) over 7 days, pre- and post-treatment.
  • Cognitive function was assessed using the Mini-Mental State Examination (MMSE); sleep disturbance severity was evaluated using JESS, AIS-J, and RBDSQ-J.

Main Results:

  • Lemborexant did not significantly improve sleep quality in DLB patients.
  • No significant differences in cognitive function (MMSE scores) were observed after Lemborexant administration.
  • Actigraphy data indicated no worsening of wake after sleep onset (WASO) or total sleep time.

Conclusions:

  • Lemborexant can be used in DLB patients without worsening cognitive function or sleep disruption.
  • The study suggests Lemborexant does not exacerbate REM sleep behavior disorder (RBD) symptoms in DLB patients.
  • These findings support the cautious use of Lemborexant for insomnia in DLB, pending further research.

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