Is Dayvigo（lemborexant) a safe sleep pill?

[Rika_Qu]

Dayvigo® (lemborexant), Eisai’s dual orexin receptor antagonist, was approved in China in recently. I am wondering if it’s the safest drug we can get on the market?
In the past I tried several other sleep drugs and they don’t work very well on me.
I tried a ‘safe’ pill Ramelteon and it halves my deep sleep duration according to the OURA ring.
I also tried low dose of trazodone and it made me drowsy.

[RTHR]

Sleep, Neurotransmitter and Longevity

Hi everyone, I’ve been suffered for insomnia for 4 years. Literally I tried all the drugs, therapies and supplements for sleeping improvement. Here I want to record some of my medication history and my own sleeping supplement, since sleeping is one of the three pillars of longevity. Correct me if I make any mistake. Many hormones and neurotransmitters regulate sleep. GABA GABA is the primary inhibitory neurotransmitter in the central nervous system. GABA Receptor Agonist is the most traditional class of sleeping medicine. It mainly targets the GABA-A Receptors, enhancing the effects of GABA, to slow down brain function. What’s more, GABA is also important for maintaining deep, uninterrupted sleep. Benzodiazepines and Non-Benzodiazepine Receptor Agonists are the mostly popular medicine. I have used lorazepam and eszopiclone for years, but every one of psychiatrists I met told me to try to stop using these drugs since they all have risks like dependence. GABA system disorder cha…

I wrote a post about sleeping drugs.
Benzodiazepines is less effective to me since I got insomnia for 3+ years.
I am trying orexin receptor antagonist these days. Orexin is another neurotransmitter that regulates sleep and generally safe to do something to it.
Bryan Johnson is trying similar drugs too.

Personally I think a good sleeping pill at least should have 3 extra characteristic on top of effectiveness:

1. moderate drug metabolism rates, likely 8h, to avoid daytime sleepiness
2. safe for long-term use, no risk of cognitive impairment, since insomnia is not easy to cure. Diphenhydramine is a negative one.
3. not metabolite by CYP450. Many psychiatric drugs need CYP450 to metabolite, which is one of the major reason why these drugs generally have higher risk of drug durg interaction. CYP450, especially CYA3A4 is really easy to inhibit by drug, supplement or even some food, but many substances need it to metabolite.

Lemborexant does not 100% meet my requirements, but I need to try.

[Jay]

Rika_Qu,

I hope this link will be useful. You should find a table of sleep drugs I created a couple of years ago. Don’t take everything you read in the table as being true because I used ChatGPT to create it.

As a note there are several orexin type sleep drugs. Quviviq has I believe the shortest half-life with possibly less of an extended next day sleepiness effect.

As an insomniac I’ve used things you mentioned and found them basically not useful or intolerable. I’ve tried Quviviq before, but didn’t see great effect. However, I’m trying it again and paying close attention to whether or not I feel rested the next day compared to other sleep aids I’ve tried.

In general, I’ve used diphenhydramine and doxylamine (doxylamine being the more effective one) as mainstays and found both to be useful. But, do they lead to early dementia? It’s a dilemma. As an alternative there is Silenor (6 mg) which I’ve used and found effective. For some, including me, after a few days using Silenore there may be a a next-day sleepiness effect that is irritating. But, getting that restful sleep with Silenor is great when I need it.

Sleep supplements: what is most effective, least habit forming, and safest?

I researched and created a list of sleep Drugs and Supplements over a year ago. I recently revised it with suggestions from ChatGPT and then put it through Perplexity for verification. Keep in mind these AI programs do make mistakes. You should research anything of interest in more detail. I’ve revised this post to include information about Sleep Architecture and Dementia Risk. The upload is also in spreadsheet form which should allow you to make your own revisions if you have Microsoft Excel or equivalent. Readability on screen is now reduced, but downloaded versions may be more easily enlarged for reading. Sleep Drugs 3.xlsx (7.0 KB) Sleep Drugs 3.pdf (57.9 KB)

[Chu_Kim]

I would say yes so far, have been on it since July and it definitely helps you sleep. But my dosage is inconsistent, skip 2 days, take 5 mg, skip 3 days, take another pill, etc. It seems to last longer than what’s suggested in the info packet, for me it feels like it’s in my system for 2-3 days, I feel more sleepy than before for sure.