Daridorexant for adults with attention deficit hyperactivity disorder (ADHD) and insomnia disorder: an exploratory study.

The main goal of this naturalistic study was to assess the effect of one month of daridorexant treatment in adults with a primary diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) and comorbid Insomnia Disorder. The working hypothesis was that daridorexant, a dual orexin receptor antagonist with demonstrated efficacy for insomnia, would improve both subjective and objective sleep quality in this clinical population. ADHD and Insomnia Disorder were clinically diagnosed by two experienced psychiatrists and further confirmed using standardized psychometric tools. Participants were evaluated at baseline and after one month of therapy using self-report questionnaires—the Insomnia Severity Index (ISI) and the Sleep Condition Indicator (SCI) —and one-week actigraphy (ActTrust 2®, Condor Instruments Ltda.) during the fourth treatment week. Actigraphy provided objective estimates of Total Sleep Time (TST), Sleep Onset Latency (SOL), Sleep Efficiency (SE), Wake After Sleep Onset (WASO), and midsleep variability (StDev Midsleep). Since several parameters were not normally distributed (SCI, SE, StDev Midsleep, SOL), non-parametric tests (Related-Samples Wilcoxon Signed Rank Test) were applied, with multiple-comparison control via Benjamini–Hochberg’s False Discovery Rate (FDR) correction (q = 0.05). After treatment, ISI and SCI scores indicated significant better perceived sleep quality, while actigraphy showed increased TST and SE as well as reduced SOL, with moderate-to-strong effect sizes. No significant changes emerged for WASO or StDev Midsleep. After FDR correction, improvements in ISI, SCI, and TST remained significant.

Author affiliation: Brain Center Firenze (BCF Research), Florence, Italy