Chronotherapeutic efficacy of suvorexant on sleep quality and metabolic parameters in patients with type 2 diabetes and insomnia

Diabetes Res Clin Pract. 2020 Nov:169:108412. doi: 10.1016/j.diabres.2020.108412. Epub 2020 Sep 8.

Abstract

Aims: This study aimed to assess the chronotherapeutic efficacy of suvorexant on subjective sleep parameters and metabolic parameters in patients with type 2 diabetes and insomnia.

Methods: Thirteen patients with type 2 diabetes who met the Pittsburg Sleep Quality index criteria for primary insomnia took suvorexant 20 mg/day (15 mg/day for ≥65 years) for 14 ± 2 weeks. The following parameters were assessed before and after the treatment: sleep diary for sleep duration and quality (i.e., sleep onset latency, waking after sleep onset, and sleep efficiency [sSE]), Insomnia Severity Index, clinical and biochemical data, continuous glucose monitoring (CGM), and validated self-administered questionnaire on food intake.

Results: Suvorexant significantly improved sSE, abdominal circumference, and sucrose intake (all p < 0.05), but did not change HbA1c, CGM parameters, or body weight. Correlation analysis revealed that changes in sSE were associated with those in HbA1c and body weight (r = -0.61 and r = -0.66, respectively; both p < 0.05).

Conclusions: Suvorexant significantly improved sleep quality and obesity-associated parameters in patients with type 2 diabetes in 14 weeks. Improvements in sleep quality were associated with improvements in glycemic control. Sleep disorder treatment using suvorexant may provide metabolic benefits for patients with type 2 diabetes.

Keywords: Insomnia; Orexin receptor antagonist; Sleep quality; Suvorexant; Type 2 diabetes.

MeSH terms

  • Aged
  • Azepines / pharmacology
  • Azepines / therapeutic use*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Chronotherapy*
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Sleep Aids, Pharmaceutical / pharmacology
  • Sleep Aids, Pharmaceutical / therapeutic use*
  • Sleep Wake Disorders / drug therapy*
  • Triazoles / pharmacology
  • Triazoles / therapeutic use*

Substances

  • Azepines
  • Sleep Aids, Pharmaceutical
  • Triazoles
  • suvorexant