Daridorexant: A new horizon in the treatment of insomnia - characteristics, safety and use in geriatric therapy

Background: Chronic insomnia affects up to 20% of the general population and is associated with significant impairment in quality of life and increased health risks. The limitations of traditional pharmacotherapy, including benzodiazepines and Z-drugs, have prompted interest in novel therapeutic agents with improved safety profiles. Aim: The aim of the authors of this study was to review the available treatments for chronic insomnia with a special focus on the most modern solutions, i.e. drugs from the dual orexin receptor antagonist (DORA) group, and to present their representative, daridorexant, as an effective and safe agent in the treatment of insomnia even in groups prone to side effects, i.e. seniors. Methods: A narrative literature review was conducted with a focus on pharmacological treatments for chronic insomnia. Special attention was given to dual orexin receptor antagonists (DORAs), particularly daridorexant, as a recent development in this drug class. Results: Daridorexant has demonstrated efficacy in the treatment of chronic insomnia with a favorable safety profile, including in older adults. Compared to traditional hypnotics, it exhibits a lower risk of residual next-day sedation, psychomotor impairment, and dependence. Conclusions: Daridorexant represents a promising alternative for managing chronic insomnia, especially in populations vulnerable to adverse effects from older hypnotics. Its mechanism of action and tolerability profile position it as a modern, evidence-based option for individualized treatment of sleep disorders.