A study published in Sleep Medicine by researchers at Rutgers, Virginia Commonwealth University, and the University of Sydney reveals that roughly 1 in 4 online reviewers of the insomnia drug lemborexant stopped or planned to stop taking it due to troubling side effects. While clinical trials reported sleep paralysis in under 2% of patients and nightmares in 1% to 3%, online reviews showed sleep paralysis in 20% of users and vivid nightmares in nearly a third. Researchers explain that blocking orexin can trigger REM sleep spillover into waking hours.
Study findings on lemborexant discontinuation
- ▪In an analysis of online reviews published in Sleep Medicine, most reviewers who stopped or planned to stop taking lemborexant had used the medication for less than a month.
- ▪A study by researchers from Rutgers, Virginia Commonwealth University, and the University of Sydney found that 70 out of 260 online reviewers (about 1 in 4) stopped or planned to stop taking the insomnia drug lemborexant.
Sleep paralysis reported in reviews
- ▪Overall, approximately 1 in 5 online reviewers of lemborexant described experiencing sleep paralysis, a temporary state of being awake but unable to move or speak.
- ▪Sleep paralysis was reported by 40% of online reviewers who stopped or planned to stop taking lemborexant, compared with 15% of other reviewers.
Vivid dreams and nightmares
- ▪Nearly one-third of online reviewers analyzing lemborexant described experiencing vivid dreams or nightmares while taking the insomnia drug.
- ▪Researchers reported that reviewers who discontinued lemborexant frequently cited vivid dreams or nightmares as a primary reason for stopping the medication.
Mechanism of lemborexant side effects
- ▪Lemborexant, approved in the U.S. in 2019, treats insomnia by blocking signals from orexin, a chemical messenger that keeps people awake.
- ▪Researchers propose that blocking orexin increases dreaming sleep, which may cause vivid dreams and body muscle shutdown to spill into waking moments.
Clinical trials versus online review data
- ▪In lemborexant's two main clinical trials, fewer than 2 in 100 participants reported sleep paralysis, and 1 to 3 in 100 reported nightmares or abnormal dreams.
- ▪The research team noted that online review data cannot establish general side effect frequency because individuals with extreme experiences are more likely to post reviews.
- ▪Study lead author Abanoub J. Armanious stated that clinical trials track side effect frequency but are less equipped to measure how much a side effect impacts a patient's decision to discontinue treatment.
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