Characteristics of patients who were able to switch from benzodiazepine hypnotics to lemborexant

OBJECTIVES: There is little evidence of insomnia treatment, especially exit strategies for hypnotics. We examined on the characteristics of patients who were able to switch from benzodiazepine hypnotics to lemborexant. METHODS: Insomnia was assessed using the Athens Insomnia Scale. Efficacy outcome assessment was the Clinical Global Impressions-Improvement scale. RESULTS: Eighty patients switched from benzodiazepine hypnotic monotherapy to lemborexant and 57 patients who continued the use of benzodiazepine hypnotics. The switched group had a significantly lower benzodiazepine hypnotic diazepam equivalent and a significantly shorter dosing period than the continued group (p < 0.001 for all). The mean Athens Insomnia Scale total score of the switched group was a significant improved (5.8 ± 3.3 to 4.0 ± 3.3; p < 0.05). The mean Clinical Global Impressions-Improvement score of the switched group was 3.3 ± 0.7. CONCLUSION: Our findings suggest that when administering benzodiazepine hypnotics, shortening the administration period, as much as possible, allows a smooth switch to safe long-term maintenance therapy using lemborexant, without exacerbating insomnia.