{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:25:42Z","timestamp":1788866742447,"version":"build-2803163510"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>Chronic insomnia is common among older adults, and its management is particularly challenging due to changes in sleep architecture, multimorbidity, and increased vulnerability to adverse drug effects. Dual orexin receptor antagonists have emerged as a novel therapeutic class with promising efficacy and tolerability profiles. However, evidence specific to older adults remains limited. Here, we performed the first systematic review and meta-analysis specifically evaluating the efficacy and safety of dual orexin receptor antagonists in elderly patients with chronic insomnia (PROSPERO CRD42024565687).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized controlled trials were identified from MEDLINE, Scopus, and ClinicalTrials.gov. Objective polysomnographic outcomes, including latency to persistent sleep, total sleep time, and wake after sleep onset, as well as subjective sleep measures, were analyzed, along with safety outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten studies met the inclusion criteria for the systematic review, with five studies contributing to the meta-analysis. The quantitative synthesis comprised 2235 patients in the experimental group and 1409 patients in the control group. Overall, compared with placebo dual orexin receptor antagonists reduced wake after sleep onset and latency to persistent sleep while increasing total sleep time after 1\u00a0month and 3\u00a0months of treatment. Importantly, dual orexin receptor antagonists increased subjective total sleep time. Finally, daridorexant showed a favorable safety profile, whereas lemborexant and suvorexant were associated with higher rates of treatment-emergent adverse events than placebo, without an increase in serious adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite limited evidence, dual orexin receptor antagonists appear effective and generally safe for treating chronic insomnia in the elderly, supporting their role as a valuable therapeutic option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsag135","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:49:08Z","timestamp":1778845748000},"source":"Crossref","is-referenced-by-count":2,"title":["Treatment of chronic insomnia in elderly adults with dual orexin receptor antagonists: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4952-9015","authenticated-orcid":false,"given":"Eleonora","family":"Rollo","sequence":"first","affiliation":[{"name":"Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro at Pia Fondazione \u201cCard. G. Panico\u201d , Tricase 73039 ,","place":["Italy"]},{"name":"Department of Neurosciences, Universit\u00e0 Cattolica del Sacro Cuore , Rome 00168 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1555-6418","authenticated-orcid":false,"given":"Annibale","family":"Antonioni","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Rehabilitation, University of Ferrara , Ferrara 44121 ,","place":["Italy"]},{"name":"IIT@UniFe Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia , Ferrara 44121 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamberto","family":"Manzoli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Bologna , Bologna 40100 ,","place":["Italy"]},{"name":"Department of Environmental and Prevention Sciences, University of Ferrara , Ferrara 44121 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Lorenzo","sequence":"additional","affiliation":[{"name":"Neuropsychophysiology Lab, Santa Lucia Foundation IRCCS , Rome 00179 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1404-4314","authenticated-orcid":false,"given":"Maria Elena","family":"Flacco","sequence":"additional","affiliation":[{"name":"Department of Environmental and Prevention Sciences, University of Ferrara , Ferrara 44121 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"issue":"6","key":"2026081400272443600_ref1","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.5664\/jcsm.7172","article-title":"Insomnia in the elderly: a review","volume":"14","author":"Patel","year":"2018","journal-title":"J Clin Sleep 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