A sleeping pill that doesn't make you sway: a new targeted insomnia treatment

November 22, 2019

Tsukuba, Japan - Insomnia is one of the most common sleep disorders, and is most commonly treated with hypnotics. However, hypnotics have motor and cognitive side effects. According to new findings from the University of Tsukuba in Japan, suvorexant, which is a recently approved and more targeted treatment, has fewer physical side effects.

The most common hypnotic agents for the treatment of insomnia are γ-aminobutyric acid (GABA) agonists, which bind to GABAA receptors to enhance the action of the inhibitory neurotransmitter, GABA. GABAA receptors are widespread, which means that GABA agonists inhibit neurons throughout the brain and spinal cord, including those that are not involved in sleep. This is not the case for suvorexant, which was approved as a treatment for insomnia in the US and Japan in 2014. According to the new study published in PNAS on November 11, suvorexant has a good efficacy and fewer side effects.

"One concern about the use of GABA agonists is their side effects - they might impair the normal ability to respond to unexpected stimuli during sleep in urgent situations," says first author Jaehoon Seol. "A drug that specifically acts on brain receptors involved in wakefulness, rather than the whole brain, could avoid this."

Suvorexant inhibits orexin receptors of the wake-promoting system, thus inhibiting wakefulness. This makes it a more targeted treatment than GABA agonists. To study whether this would result in less severe side effects, the researchers conducted a randomized controlled trial with 30 healthy men in a sleep lab. Participants took either suvorexant, brotizolam (a GABA agonist), or a placebo before falling asleep and were then woken up 90 minutes later. Their cognitive and physical functioning was then tested.

Suvorexant induced fewer impairments in body balance upon awakening than brotizolam. This could be associated with the cerebellum, a part of the brain that coordinates balance. Namely, the cerebellum contains GABAA receptors but not orexin receptors. In this case, brotizolam may have affected cerebellar functioning, while suvorexant did not.

"This is the first study to investigate the potential side effects of suvorexant and to compare these with those of brotizolam," says Masashi Yanagisawa, lead author of the study. "Also, suvorexant was just as effective as brotizolam in the treatment of insomnia, with comparable effects on sleep duration and efficiency."

With a reported prevalence of 10-60%, insomnia is considered a serious health issue. These new findings are potentially significant and could lead to further large-scale studies in patients with insomnia.
-end-


University of Tsukuba

Related Insomnia Articles from Brightsurf:

Insomnia treatment offers relief
Insomnia causing sleepless nights, daytime fatigue and poor health outcomes is a cycle worth busting, experts say, with depression, anxiety and stress a common co-occurrence.

Reduction in insomnia symptoms associated with non-invasive neurotechnology
For people with chronic insomnia, a good night's sleep is elusive.

The neurons that connect stress, insomnia, and the immune system
Researchers have pinpointed the circuit in the brain that is responsible for sleepless nights in times of stress--and it turns out that circuit does more than make you toss and turn.

Refined carbs may trigger insomnia, finds study
Women who consumed a diet high in added sugars and refined carbohydrates had a greater risk of developing insomnia, a new study by researchers at Columbia University has found.

Disturbed childhood can lead to adult insomnia
Parents should help their children with better sleep patterns, along with any problem behavioural issues, because this can lead to severe insomnia in middle age, a groundbreaking new study shows.

Study compares different strategies for treating insomnia
New research published in Worldviews on Evidence-Based Nursing indicates that for treating insomnia, stimulus control therapy (which reassociates the bed with sleepiness instead of arousal) and sleep restriction therapy are effective, and it is best to use them individually rather than together.

Brain cells involved in insomnia identified
An international team of researchers has identified, for the first time, the cell types, areas and biological processes in the brain that mediate the genetic risk of insomnia.

Mice sleeping fitfully provide clues to insomnia
Researchers at Washington University School of Medicine in St. Louis -- working with mice with sleep problems similar to those experienced by people with the genetic disease neurofibromatosis type 1 (NF1) -- believe the animals will help shed light on insomnia linked to NF1 or other factors.

Insomnia has many faces
Researchers at the Netherlands Institute for Neuroscience revealed that there are five types of insomnia.

Light pollution may cause insomnia in older adults
A new study is the first population-based investigation to report a significant association between artificial, outdoor light exposure at night and insomnia, as indicated by older adults' use of hypnotic drugs.

Read More: Insomnia News and Insomnia Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.