Study IDs Real-World Reasons for Lemborexant Discontinuation

THURSDAY, Nov. 5, 2026 (HealthDay News) — Disturbing side effects, not efficacy, may influence whether people discontinue lemborexant for insomnia, according to a study published online Oct. 29 in Sleep Medicine.

Abanoub J. Armanious, from the Robert Wood Johnson Medical School at Rutgers University in Piscataway, New Jersey, and colleagues sought to characterize real-world patient experiences with lemborexant, including perceived benefits, side effects, and overall treatment satisfaction, and how these experiences influence treatment adherence and discontinuation. The analysis included 260 user-generated online reviews.

The researchers found that nearly one-third of respondents (30 percent) described meaningful improvements in sleep quality following initiation with lemborexant, and half (50 percent) reported minimal or no perceived benefit. More than two-thirds of respondents (68 percent) reported at least one adverse outcome associated with treatment, including most frequently oneiric experiences (e.g., vivid dreams or nightmares) and worsening of sleep quality. There were strong associations between lower efficacy ratings and discontinuation intent with self-reported sleep paralysis (40 percent of those intending to discontinue), intensified oneiric phenomena, and next-day somnolence. Just over six in 10 (61 percent) used lemborexant for less than one month, but higher perceived efficacy ratings were associated with longer treatment duration.

“A clinical trial can tell you how often side effects occur,” Armanious said in a statement. “It is less equipped to tell you how much that side effect matters to the person living it. A side effect can be rare and still be the reason someone discontinues treatment.”

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