{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:12:33Z","timestamp":1789524753169,"version":"build-2803163510"},"reference-count":26,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:00:00Z","timestamp":1672358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and aim: Pancreato-biliary patients who undergo endoscopic procedures have high potential risk of delirium. Although benzodiazepine has traditionally been used to treat insomnia, this drug might increase delirium. Lemborexant may be useful for patients with insomnia, without worsening delirium, although there is no evidence for high-risk patients with pancreato-biliary disease. The aim of this pilot study was to evaluate the safety and efficacy of lemborexant for insomnia and the frequency of delirium after endoscopic procedures under deep sedation in patients with pancreato-biliary disease. Method: This retrospective study included consecutive patients who were administered lemborexant after endoscopic procedures for pancreato-biliary disease between September 2020 and June 2022. The primary outcome of this study was evaluation of the safety and efficacy of lemborexant for insomnia. Frequency of delirium was the secondary outcome. Result: In total, 64 patients who had the complication of insomnia after an endoscopic procedure were included in the study. Risk factors for delirium were advanced age (n = 36, 56.3%), dementia (n = 10, 15.6%), and regular alcohol use (n = 13, 20.3%), as well as the sedatives midazolam and pentazocine that were administered to all patients at the time of the endoscopic procedure. Successful asleep was achieved by 61\/64 patients (95.3%). No fall event was observed during the night following the procedure in any patient. However, mild consciousness transformation was observed in one patient. Conclusions: In conclusion, lemborexant use may be effective and safe for use after endoscopic procedures in pancreato-biliary patients, without increasing the risk of delirium.<\/jats:p>","DOI":"10.3390\/jcm12010297","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T03:00:59Z","timestamp":1672628459000},"page":"297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Can Lemborexant for Insomnia Prevent Delirium in High-Risk Patients with Pancreato-Biliary Disease after Endoscopic Procedures under Deep Sedation?"],"prefix":"10.3390","volume":"12","author":[{"given":"Takeshi","family":"Ogura","sequence":"first","affiliation":[{"name":"Endoscopy Center, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"},{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saori","family":"Ueno","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Okuda","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobu","family":"Nishioka","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Miyano","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaro","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimi","family":"Bessho","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuki","family":"Tomita","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Hattori","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1001\/jama.286.21.2703","article-title":"Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU)","volume":"286","author":"Ely","year":"2001","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1093\/ageing\/afaa040","article-title":"The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: A systematic review and meta-analysis study","volume":"49","author":"Gibb","year":"2020","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1001\/archinternmed.2007.4","article-title":"One-year health care costs associated with delirium in the elderly population","volume":"168","author":"Leslie","year":"2008","journal-title":"Arch. 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