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Not yet recruitingNCT07847021Updated Sep 29, 2026

A Multicenter Observational Study of Daridorexant in the Treatment of Insomnia

An observational study in Insomnia, sponsored by Shanghai Mental Health Center. Not yet recruiting at 25 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-29.

Sponsored by Shanghai Mental Health Center · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
500
Ages
18 Years and older
Sex
All
01

Study summary

This study aims to evaluate the effectiveness and safety of daridorexant, a novel dual orexin receptor antagonist (DORA), in patients with insomnia. The study population consists of patients aged 18 years and older who present with core insomnia symptoms as defined in the Chinese Guidelines for the Diagnosis and Treatment of Insomnia (2023 Edition); eligible patients will receive daridorexant for 16 weeks and will be followed up for improvement in insomnia symptoms and for the occurrence of adverse events, so as to provide real-world evidence to inform the optimization of clinical treatment strategies for insomnia.

Read the detailed description

Background: Insomnia is a highly prevalent sleep disorder that markedly impairs quality of life, with the prevalence of insomnia symptoms ranging from 30% to 48%. Long-term use of benzodiazepines may result in daytime sleepiness, cognitive impairment, tolerance, and risk of dependence, and has even been associated with early-onset dementia; daridorexant avoids many of the adverse effects associated with conventional hypnotic agents. Daridorexant was approved for marketing in China in June 2025; however, large-sample real-world studies of daridorexant are currently lacking. Hypothesis: Daridorexant administered for 16 weeks significantly improves symptoms in patients with insomnia, with a favorable safety profile. Design: A multicenter, prospective, single-arm, observational study with a planned enrollment of 500 patients (assuming an estimated dropout rate of 15%). Patients will receive treatment for 16 weeks, and outcomes will be assessed as the change from baseline in the Insomnia Severity Index (ISI), in sleep parameters (sleep efficiency [SE] and total sleep time [TST]), in the Epworth Sleepiness Scale (ESS) score, in the Clinical Global Impression-Improvement (CGI-I) scale, in the Patient Global Impression-Improvement (PGI-I) scale, and in the 36-Item Short-Form Health Survey (SF-36).

02

Conditions studied

  • Insomnia

Keywords

  • daridorexant
  • insomnia
  • dual orexin receptor antagonist
  • real-world study
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Adults (aged ≥18 years) who agree to participate in the study and core insomnia symptoms documented by the physician during routine clinical care, as defined in the Chinese Guidelines for the Diagnosis and Treatment of Insomnia (2023 Edition) , with symptoms occurring at least 3 times per week and accompanied by daytime functional impairment or daytime distress:

Inclusion criteria

  1. Adults (aged ≥18 years) of either sex who agree to participate in the study.
  2. Core insomnia symptoms documented by the physician during routine clinical care, as defined in the Chinese Guidelines for the Diagnosis and Treatment of Insomnia (2023 Edition) (meeting at least one of the following criteria), with symptoms occurring at least 3 times per week and accompanied by daytime functional impairment or daytime distress:

    1. Difficulty initiating sleep (sleep latency exceeding 30min in adults);
    2. Difficulty maintaining sleep (≥2 nocturnal awakenings);
    3. Early morning awakening, reduced sleep quality, and reduced total sleep time (usually \<6.5h).
  3. Insomnia Severity Index (ISI) score >7.
  4. Ability to ensure at least 7 hours of time in bed.
  5. Participants sign the informed consent form after the study drug prescription has been issued.

Exclusion criteria

Exclusion Criteria:

  1. Participants who are unable to understand and complete the various scales and questionnaire assessments.
  2. Patients whose insomnia symptoms have shown no significant improvement after standardized treatment with two or more concomitant hypnotic agents (including benzodiazepines, non-benzodiazepine hypnotics, orexin receptor antagonists, and sedating antidepressants/antipsychotics).
  3. Generalized Anxiety Disorder-7 (GAD-7) score ≥15.
  4. Patient Health Questionnaire-9 (PHQ-9) score ≥ 20.
  5. Patients who answer "yes" to Item 4 or Item 5 of the suicidal ideation section of the Columbia-Suicide Severity Rating Scale (C-SSRS), or who have a history of suicide attempt in the suicidal behavior section.
  6. Patients with severe mental disorders (including but not limited to schizophrenia, schizoaffective disorder, paranoid psychosis, bipolar disorder, mental disorder due to epilepsy, and intellectual developmental disorder with comorbid mental disorder) who are currently in an acute episode or whose condition is unstable, and who, in the investigator's judgment, may compromise trial adherence, be unable to complete the full follow-up, or present a significant safety risk.
  7. A history of serious illness, concomitant medication use, cognitive impairment, or uncontrolled poor sleep habits that, in the investigator's judgment, would interfere with study assessments or participant safety.
  8. Any contraindication or other condition precluding use as specified in the precautions of the package insert (e.g., hypersensitivity to daridorexant or to any of the excipients, narcolepsy, severe hepatic impairment, pregnancy, or lactation).
  9. Any other condition that the clinician judges to render participation inappropriate.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
500 participants (estimated)
Patient registry
No

Groups and cohorts

  • Daridorexant Treatment Group

    All enrolled patients receive daridorexant treatment for a 16-week study period.

    Drug: Daridorexant 50 mg

Interventions

  • DrugDaridorexant 50 mg

    Daridorexant hydrochloride tablets (50mg, 20 tablets/box; distributor: Jiangsu Simcere Pharmaceutical Co., Ltd.; store at no more than 30°C). Administered orally: daridorexant 50mg, taken no more than once per night immediately before bedtime, with at least 7 hours remaining before the planned time of awakening.

05

What researchers measure

Primary outcomes

  1. Change in Insomnia Severity Index (ISI) score

    Change from baseline in the Insomnia Severity Index (ISI) score at week 4 of treatment. ISI total score ranges 0-28; higher scores represent more severe insomnia (worse outcome).

    Time frame: 4 Week

Secondary outcomes

  1. Change from baseline in the Insomnia Severity Index (ISI) score at Weeks 8 and 12

    Change from baseline in the Insomnia Severity Index (ISI) score at Weeks 8 and 12 of treatment. The Insomnia Severity Index is a 7-item self-rated scale with total scores ranging from 0 to 28. Higher ISI scores indicate greater severity of insomnia (worse outcome).

    Time frame: Weeks 8 and 12

  2. Insomnia remission rate

    Insomnia remission rate at Weeks 4, 8, and 12, defined as the proportion of patients with an ISI score \<8;

    Time frame: Weeks 4, 8, and 12

  3. Proportion of treatment responders

    Proportion of treatment responders among patients with moderate-to-severe insomnia at Weeks 4, 8, and 12 (responder defined as a total ISI reduction of ≥6 points from baseline; moderate-to-severe insomnia defined as an ISI score ≥15);

    Time frame: Weeks 4, 8, and 12

  4. Change from baseline in sleep efficiency (SE)

    Change from baseline in sleep efficiency (SE) at Weeks 4, 8, and 12 of treatment. Sleep efficiency is calculated as the percentage of time spent asleep relative to time in bed. SE ranges from 0% to 100%; higher values indicate better sleep.

    Time frame: Weeks 4, 8, and 12

  5. Change from baseline in the Epworth Sleepiness Scale (ESS) score

    Change from baseline in the Epworth Sleepiness Scale (ESS) score at Weeks 4, 8, and 12. ESS total score ranges 0-24; higher scores represent more severe daytime sleepiness (worse outcome).

    Time frame: Weeks 4, 8, and 12

  6. Change from baseline in the Clinical Global Impression-Improvement (CGI-I) scale score

    Change from baseline in the Clinical Global Impression-Improvement (CGI-I) scale score at Weeks 4, 8, and 12 of treatment. The CGI-I is a 7-point clinician-rated scale ranging from 1 to 7. Lower scores indicate greater clinical improvement (better outcome).

    Time frame: Weeks 4, 8, and 12

  7. Change from baseline in the Patient Global Impression-Improvement (PGI-I) scale score

    Change from baseline in the Patient Global Impression-Improvement (PGI-I) scale score at Week 16 of treatment. The PGI-I is a 7-point patient-rated scale ranging from 1 to 7. Lower scores indicate greater patient-perceived clinical improvement (better outcome).

    Time frame: Week 16

  8. Change from baseline in the 36-Item Short-Form Health Survey (SF-36)

    Change from baseline in the 36-Item Short-Form Health Survey (SF-36) score at Week 12 of treatment. The SF-36 is a self-reported health questionnaire comprising 8 domains. Domain and summary scores range from 0 to 100. Higher scores indicate better health-related quality of life (better outcome).

    Time frame: Week 12

  9. Change from baseline in the Insomnia Severity Index (ISI) score across the three treatment modalities

    Change from baseline in the Insomnia Severity Index (ISI) score at Weeks 4, 8, and 12 of treatment, compared across three treatment modalities (treatment-naïve therapy, switch therapy, and add-on therapy). The Insomnia Severity Index is a 7-item self-rated scale with total scores ranging from 0 to 28. Higher ISI scores indicate greater severity of insomnia (worse outcome).

    Time frame: Weeks 4, 8, and 12

  10. Change in the pre-existing treatment regimen in the non-treatment-naïve group

    Change in the pre-existing treatment regimen in the non-treatment-naïve group at Weeks 4, 8, and 12 (success rate of dose reduction or discontinuation of prior medications);

    Time frame: Weeks 4, 8, and 12

  11. Daridorexant continuation rate and reasons for discontinuation

    Daridorexant continuation rate and reasons for discontinuation at Weeks 4, 8, 12, and 16 (continuation rate defined as the percentage of participants who remain on daridorexant treatment, irrespective of treatment modality).

    Time frame: Weeks 4, 8, 12, and 16

06

Study locations

25 sites
  • Chaohu Hospital of Anhui Medical University
    Chaohu, Anhui 238000, China
  • The Second People's Hospital of Hefei
    Hefei, Anhui 230011, China
  • China-Japan Friendship Hospital
    Beijing, Beijing Municipality 100029, China
  • Chinese People's Liberation Army (PLA) General Hospital
    Beijing, Beijing Municipality 100039, China
  • Beijing Huilongguan Hospital
    Beijing, Beijing Municipality 100096, China
  • Fuzhou Second General Hospital Neuropsychiatric Prevention and Treatment Hospital
    Fuzhou, Fujian 350412, China
  • The First People's Hospital of Foshan
    Foshan, Guangdong 528000, China
  • The Fourth People's Hospital of Shantou
    Shantou, Guangdong 515021, China
  • Zhongshan People's Hospital
    Zhongshan, Guangdong 528403, China
  • Harbin First Specialized Hospital
    Harbin, Heilongjiang 150000, China
  • The First Affiliated Hospital of Zhengzhou University
    Zhengzhou, Henan 450000, China
  • Wuhan Mental Health Center
    Wuhan, Hubei 430030, China
  • Hunan Provincial People's Hospital
    Changsha, Hunan 410000, China
  • Nanjing Brain Hospital
    Nanjing, Jiangsu 210029, China
  • Suzhou Guangji Hospital
    Suzhou, Jiangsu 215004, China
  • The First Affiliated Hospital of Nanchang University
    Nanchang, Jiangxi 330006, China
  • China-Japan Union Hospital of Jilin University
    Changchun, Jilin 130033, China
  • Shaanxi Provincial People's Hospital
    Xi'an, Shaanxi 710068, China
  • Renji Hospital, Shanghai Jiao Tong University School of Medicine
    Shanghai, Shanghai Municipality 200000, China
  • Shanghai Mental Health Center
    Shanghai, Shanghai Municipality 200030, China
  • Shanghai Putuo District People's Hospital
    Shanghai, Shanghai Municipality 200333, China
  • Taiyuan Psychiatric Hospital
    Taiyuan, Shanxi 030045, China
  • West China Hospital, Sichuan University
    Chengdu, Sichuan 610041, China
  • The First People's Hospital of Yunnan Province
    Kunming, Yunnan 650000, China
  • The Second Affiliated Hospital, Zhejiang University School of Medicine
    Hangzhou, Zhejiang 310000, China
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07847021
Lead sponsor
Shanghai Mental Health Center
Responsible party
Sponsor
First posted
Sep 29, 2026
Start date
Oct 1, 2026 (estimated)
Primary completion
Jan 31, 2028 (estimated)
Completion
Jul 31, 2028 (estimated)
Last update
Sep 29, 2026

Study contacts

Wenzheng Wang
Contact
fffty@163.com
021-34773758

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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