OBJECTIVES: Insomnia is a highly prevalent sleep disorder, associated with widespread societal, economic and humanistic burden. Therefore, effective treatment is crucial to reduce the substantial burden of insomnia on patients, payers and society. Suvorexant, marketed as Belsomra®, was approved to treat insomnia in 2014. This study evaluated healthcare provider (HCP) experiences with suvorexant and other pharmacotherapies (for example, benzodiazepines, non-benzodiazepines sleep agents such as zolpidem, eszopiclone, zaleplon, or antidepressants) in a real‑world setting.

METHODS: This United States (US) cross-sectional web-based survey included 180 HCPs treating patients for sleep-related symptoms with (n=119) and without (n=61) experience prescribing suvorexant. All data were collected between October and November 2016. Analyses were conducted for the total sample and according to stratifications including HCP specialty and suvorexant experience. Multivariable analyses assessed the relationship between pharmacotherapies and key sleep domains.

RESULTS: According to HCPs, sleep onset latency (48%) and waking after sleep onset (31%) were the most common patient-reported presenting symptoms of insomnia. Most HCPs (89%) reported their patients had tried ≥2 insomnia pharmacotherapies and 70% of HCP’s indicated that ≥25% of their patients did not respond to their first-line insomnia treatment. Providers were less likely to report that other treatments (benzodiazepines, non-benzodiazepine sleep treatments and antidepressants) significantly improved next day ill-effects or significantly improved the ability to wake and function quickly compared with suvorexant (odds ratios that providers would rate other treatments significantly improve the sleep domain with suvorexant as the reference, 0.34 – 0.53, all p-values < 0.05).

CONCLUSIONS: HCPs treating patients for sleep-related symptoms reported that suvorexant demonstrated improvement in total sleep time, reduced next day ill-effects of insomnia, and improved the ability for patients to wake and function quickly, versus alternative pharmacotherapies. There are clear opportunities for suvorexant to be more widely available as a first-line therapy for patients with insomnia.