Placebo Baseline: A Restless Night
Insomnia unmanaged — long latency, fragmented sleep.
- 65 min: Sleep latency (time to fall asleep)
- 4–6: Nighttime awakenings (per night, placebo)
- 95 min: Wake after onset (total WASO)
- 72%: Sleep efficiency (time asleep in bed)
Prolonged sleep onset
Falling asleep takes over an hour on placebo.
Frequent awakenings
Sleep fractures into short, repeatedly broken segments.
Shallow architecture
Little deep sleep, poor overnight restoration.
Placebo nights average 65 minutes just to fall asleep.
Daridorexant: Dose Before Bedtime
A dual orexin antagonist taken before sleep.
- 25/50 mg: Dose options (once nightly)
- ~8 hrs: Half-life (plasma elimination)
- DORA: Mechanism (dual orexin receptor antagonist)
- 30 min: Time to bed (recommended dosing window)
Orexin blockade
Blocks wake-promoting orexin receptors OX1R and OX2R.
Dose selection
Higher dose deepens and lengthens the sleep effect.
Bedtime timing
Taken within 30 minutes of going to bed.
Daridorexant blocks orexin without disrupting natural sleep architecture.
Reduced Sleep Latency
Onset drops from over an hour to about 20 minutes.
- 20 min: Latency, 50 mg (vs 65 min placebo)
- -45 min: Latency reduction (vs placebo baseline)
- faster: Time to N2 (quicker light-sleep entry)
- unchanged: REM timing (normal onset sequence)
Faster onset
Orexin blockade shortens time to first sleep.
Dose response
50 mg cuts latency more than 25 mg.
Preserved sequence
Normal sleep-stage order still occurs, just sooner.
Daridorexant 50 mg nearly halves the time to fall asleep.
Improved Sleep Maintenance
Nighttime awakenings shrink in number and duration.
- -50 min: WASO reduction (vs placebo)
- fewer: Awakenings (per night on treatment)
- 88%: Sleep efficiency (50 mg, full effect)
- increased: Deep sleep (greater N3 proportion)
Fewer disruptions
Middle-of-night awakenings drop noticeably on treatment.
Shorter wake bouts
Each awakening resolves back to sleep faster.
Consolidated cycles
Sleep cycles run longer without interruption.
Wake after sleep onset falls by roughly half on daridorexant.
Full-Night Comparison
Two full hypnograms reveal the treatment effect.
- +1.2 hr: Total sleep time (vs placebo)
- +16 pts: Efficiency gain (72% → 88%)
- -45 min: Latency gain (65 → 20 min)
- -50 min: WASO gain (95 → 45 min)
Onset contrast
Daridorexant trace reaches sleep far sooner.
Maintenance contrast
Placebo trace shows repeated spikes back to wake.
Overall gain
Combined effect yields more consolidated, restorative sleep.
Across the night, daridorexant delivers more sleep with fewer interruptions.