Daridorexant in patients with primary headaches and chronic insomnia: An observational study

Aim There is an unquestionable, clinical and pathophysiological, relationship between sleep and primary headaches. We explored the effect of daridorexant, a novel dual orexin receptor antagonist, in patients with primary chronic headache and chronic insomnia. Methods Retrospective chart review of patients with primary chronic headache and insomnia who had started treatment with daridorexant 50 mg for their sleep disorder. Headaches were assessed using a calendar and sleep quality using the Patient Global Impression of Change (PGIC) scale (1 no benefit–7 absolute response). Results We included 12 patients (10 women; ages 36–72 years). In 6 (50%) patients, insomnia improved (PGIC ≥ 5); mean PGIC being 4.9. In contrast, only one patient (8.3%) experienced a response (≥50% reduction) in their headaches. Mild adverse events were seen in two patients. Conclusions In patients with primary chronic headaches, daridorexant improved the subjective quality of sleep in half of the patients but had no clear effect on the frequency or intensity of chronic headaches.