Insomnia can make it difficult to get through the day. Whether you struggle to fall asleep, stay asleep, or both, poor sleep can affect your mood, alertness, and overall health. When these problems last for at least three months and occur at least three nights a week, it is known as chronic insomnia. Although chronic insomnia can affect anyone, it is more common in women than in men.
If you have chronic insomnia, you may be wondering whether a prescription medicine could help. One treatment option for insomnia is Dayvigo (lemborexant). Dayvigo is a prescription sleep medicine that the FDA approved in 2019. It works differently from many older insomnia medicines and may help some people get a better night’s rest.
This article covers how Dayvigo works for insomnia, how it was studied, and more. You may also be interested in learning more about Dayvigo side effects and Dayvigo interactions.
How Does Dayvigo Work for Insomnia?
Dayvigo works by targeting a natural brain signaling pathway called the orexin system. Orexins are chemicals that help keep you awake, alert, and focused during the day.
As bedtime approaches, the brain normally reduces wake-promoting signals and allows sleep-promoting signals to take over. In people with insomnia, the brain may continue sending wakefulness signals when it should be preparing for sleep.
Dayvigo belongs to a group of medicines called dual orexin receptor antagonists. It works by temporarily blocking two orexin receptors in the brain. These receptors normally receive messages from orexin chemicals (orexin A and orexin B) that promote wakefulness.
By blocking these receptors, Dayvigo reduces the brain’s “awake” signals and makes it easier for the body to transition into sleep and stay asleep until it’s time to wake up.
How Do I Take Dayvigo?
The usual starting dose of Dayvigo is 5 milligrams (mg) taken once at night, right before you go to bed.
If needed, your health care provider may increase your dose to 10 mg. The right dose will depend on how well Dayvigo works for you, how well you tolerate it, and other factors. For example, some people may need to stay at a maximum dose of 5 mg if they have liver problems or take certain medicines that interact with Dayvigo.
Take Dayvigo exactly as prescribed by your health care provider. The information above describes the dosage typically recommended by the drugmaker.
Here are some important tips for taking Dayvigo:
- Do not take more than one dose in the same night, even if you wake up during the night and have trouble falling back asleep.
- Only take Dayvigo if you can stay in bed long enough to get at least seven hours of sleep before you need to be awake and active again. Taking Dayvigo when you cannot get a full night’s sleep may increase your risk of side effects (such as next-day drowsiness, slowed thinking, or impaired alertness).
- You can take Dayvigo with or without food. However, taking it with a meal or soon after eating may cause it to take longer to start working. If you want Dayvigo to start working sooner, take it without food or a few hours after eating.
If Dayvigo does not seem to be working well enough, do not increase your dose on your own. Talk with your health care provider to see whether a dose adjustment or another treatment approach may be needed.
Note that people who work night shifts or regularly sleep during the day can still use Dayvigo. In these situations, “night” and “bedtime” refer to your main sleep period, even if it occurs during daylight hours. Most importantly, take Dayvigo immediately before going to sleep, and make sure you have at least seven hours available for sleep before you need to be awake and active again.
How Was Dayvigo Studied for Insomnia?
Dayvigo was studied in two clinical trials involving adults with chronic insomnia. The studies included people who had trouble with sleep onset (falling asleep), sleep maintenance (staying asleep), or both.
In study 1, people were randomly assigned to take either Dayvigo or a placebo (a pill with no active medicine) each night for six months. Neither the participants nor the researchers knew who was getting which treatment. The study included 971 adults, described as follows:
- The midpoint age was 55 (range, 18-88 years). Some (28%) of the participants were 65 years or older.
- 68% of participants were female, and the rest were male.
- Most (72%) were White, 17% were Japanese, 8% were Black or African American, and the rest identified as being of other races.
Study 2 focused on older people with insomnia (women aged 55 and older and men aged 65 and older). Participants were randomly assigned to take Dayvigo, a placebo, or another sleep medicine for one month. No one knew who was getting which treatment. The study included 1,006 adults, described as follows:
- The midpoint age was 63 (range, 55-88 years).
- 86% of participants were female, and the rest were male.
- Most (72%) were White, 25% were Black or African American, and 2% identified as being of other races.
The main goal of the studies was to determine whether Dayvigo helped people fall asleep faster and stay asleep longer. The researchers used many measures of sleep during the studies. These included how long it took people to fall asleep, how much time they spent awake after first falling asleep, and the percentage of time spent asleep while in bed. Some measurements were based on sleep diaries completed by participants, while others were measured during overnight sleep studies.
What Are the Main Benefits of Dayvigo Based on Studies?
In both studies, people who took Dayvigo fell asleep faster than those who received a placebo.
In the six-month study (study 1), people taking Dayvigo spent more of their time in bed asleep compared with those taking a placebo. People taking Dayvigo also spent about 13-18 fewer minutes awake during the night after they first fell asleep.
In the one-month study of older adults (study 2), people taking Dayvigo spent a greater percentage of their time in bed asleep compared with those taking a placebo. People taking Dayvigo also spent about 24-25 fewer minutes awake during the night after first falling asleep.
Keep in mind that your results may differ from what was seen in clinical trials.
Can I Take Dayvigo Long Term?
Yes. If Dayvigo is working well for you and not causing troublesome side effects, your health care provider may recommend taking it long term.
Long-term use of Dayvigo was studied in a clinical trial that included nearly 950 adults who took Dayvigo for up to 12 months. The study found that the benefits of Dayvigo for falling asleep and staying asleep were maintained over time.
Overall, Dayvigo was generally well tolerated. Most side effects were mild or moderate, and serious side effects were uncommon. The most common side effect was next-day sleepiness (somnolence), which was reported more often with Dayvigo than with placebo and was more common with the higher dose.
This study also looked for potential long-term safety concerns such as falls, changes in laboratory tests, heart-related measurements, body weight, and suicidal thoughts or behaviors. No major safety concerns were identified.
These results suggest that Dayvigo can be an effective and generally well-tolerated option for people who need ongoing treatment for chronic insomnia. Your health care provider can help you decide if and how long you should take Dayvigo.
What if I Wake Up During the Night After Taking Dayvigo?
If you wake up during the night after taking Dayvigo, do not take another dose. Try to stay in bed, if possible. If you get out of bed, you could feel unsteady, fall, or have trouble staying alert or remembering things.
In one study, adults were awakened about four hours after taking Dayvigo. Compared with those taking a placebo, people taking Dayvigo had more trouble with balance and performed worse on some tests of attention and memory. However, Dayvigo did not appear to make it harder for people to wake up in response to a loud sound during the night.
If you must get out of bed after taking Dayvigo, use caution or get help. Move slowly when standing up, turn on a light if possible, and watch for tripping hazards, such as rugs, cords, or pets.
Even if you feel awake, avoid driving, operating machinery, or doing other activities that require full alertness if you got less than seven hours of sleep after taking Dayvigo or took more than your prescribed dose. Some people may still feel drowsy the next day. Wait until you feel fully awake before driving or doing anything that could be dangerous.
How Much Does Dayvigo Cost?
The amount you pay for Dayvigo may depend on many factors, such as your insurance coverage, the pharmacy you use, and whether you qualify for any assistance programs.
A financial assistance program is available from Eisai, the maker of Dayvigo. It may help reduce the amount you have to pay for your prescription. Visit this website or call 866-349-3026 to learn more about financial support options.
