Author

Danielle Hart

Date of Award

12-2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine if Suvorexant (Belsomra) is effective in reducing wakefulness after sleep onset in healthy patients diagnosed with insomnia that are 18 years old or older.

STUDY DESIGN: Systematic review of three published, randomized controlled trials (doubleblind, placebo-controlled) between 2012-2014, all English.

DATA SOURCES: Three randomized controlled trials published between 2012-2014 were found using PubMed.

OUTCOMES MEASURED: Polysymnography, psychomotor performance test, PSG measurements of sleep, visual scoring, efficacy assessed with an electronic diary, Sheehan Disability Scale, vitals, EKGs, PE, MVAV questionnaire, QIDS-SR to assess mood, Tyler Withdrawal Symptom Questionnaire

RESULTS: The first study, Michelson et al proved that after one year, suvorexant showed greater reduction in wakefulness after sleep onset (WASO) than placebo with a change in baseline -33.5 (-37.4 to -29.7) compared to placebo, -23.8 (-29.3 to -18.3). Herring et al proved a reduction in WASO as well with a -33.2 (-46.3, -20.2) change in baseline compared to placebo. Sun et al showed a reduction in WASO with a suvorexant 95% CI (11.61, 18.12) vs placebo (16.61, 25.91).

CONCLUSION: According to the three double-blind randomized controlled trials, Suvorexant (Belsomra) is effective in reducing wakefulness after sleep onset in healthy patients with insomnia over the age of 18 years old.

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