{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:05:16Z","timestamp":1783915516367,"version":"3.55.0"},"reference-count":10,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Dual orexin receptor antagonists (DORAs) such as suvorexant are effective treatments for insomnia but are associated with rapid eye movement (REM) sleep\u2013related adverse effects. While sleep paralysis and hypnagogic hallucinations are recognised, cataplexy is not typically reported. We describe a 39\u2010year\u2010old male US Navy Veteran with chronic pain, long\u2010standing insomnia and anxiety who developed recurrent, emotionally triggered episodes of bilateral ptosis, slurred speech, unsteadiness and subjective \u201ceuphoric\u201d sensations shortly after initiating suvorexant. Neurologic evaluation, electroencephalography, electromyography and brain imaging were unrevealing. Multiple sleep latency testing demonstrated normal mean sleep latency without sleep\u2010onset REM periods, excluding narcolepsy. Polysomnography revealed mild obstructive sleep apnea. Symptoms diminished substantially following suvorexant discontinuation and multimodal treatment including cognitive behavioural therapy for insomnia, escitalopram and continuous positive airway pressure therapy, though mild residual symptoms persisted. This case suggests that suvorexant may provoke cataplexy\u2010like phenomena via REM\u2010intrusion mechanisms in susceptible individuals. Clinicians should monitor for atypical motor or speech symptoms in patients prescribed DORAs, particularly those with psychiatric comorbidity or sleep fragmentation.<\/jats:p>","DOI":"10.1111\/jsr.70310","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T01:44:46Z","timestamp":1770947086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cataplexy\u2010Like Episodes Following Suvorexant Use in a Non\u2010Narcoleptic Patient: A Brief Report"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6323-9121","authenticated-orcid":false,"given":"Nishat","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of California San Diego  La Jolla California USA"},{"name":"VA San Diego Healthcare System  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Finch","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Sleep Medicine and Physiology University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"International Classification of Sleep Disorders. 3rd Ed. Text Revision (ICSD\u20103\u2010TR)","author":"American Academy of Sleep Medicine","year":"2023"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40268-018-0256-6"},{"key":"e_1_2_9_4_1","unstructured":"FDA.2020.\u201cBELSOMRA (Suvorexant) Prescribing Information.\u201d"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2014.10.003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab043"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70053-5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsad293"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.wco.0000044800.53746.5a"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pharmtox-010510-100528"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-012-0145-6"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jsr.70310","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T03:36:49Z","timestamp":1783913809000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.70310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/jsr.70310"],"URL":"https:\/\/doi.org\/10.1111\/jsr.70310","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]},"assertion":[{"value":"2025-09-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70310"}}