Delirium, associated with disrupted sleep, is common among older hospitalized adults. In addition to presenting immediate management issues, delirium can increase the long-term risk of dementia, institutionalization and mortality. Prior studies suggest that some specific sleep-promoting agents may reduce delirium. A recent study points specifically to the sleep medication suvorexant as a possible way to help prevent delirium in this vulnerable population.
Researchers conducted a double-blind, placebo-controlled, phase 3 randomized clinical trial, including 50 hospitals in Japan between Oct. 22, 2020, and Dec. 23, 2022. The study population included Japanese adults aged 65 to 90 years who were at high risk for developing delirium and had been hospitalized for acute disease or elective surgery.
The study, published in JAMA Network Open, found that 17% of participants taking suvorexant developed delirium compared with 27% in the placebo group. However, this difference did not reach statistical significance, leaving room for further investigation.
Interestingly, a deeper dive into the data revealed that suvorexant might be particularly effective in preventing delirium with a hyperactive component—the type often associated with agitation and hallucinations. This finding could be relevant for hospital staff and caregivers who struggle to manage these challenging symptoms in older hospitalized adults.
Safety is always a concern when introducing new medications to older adults, but the study found that suvorexant’s safety profile was generally similar to that of the placebo. This suggests that the medication could be well-tolerated in older hospitalized adults.
While the results are encouraging, the researchers emphasize the need for additional studies to confirm suvorexant’s potential in reducing delirium, particularly the hyperactive type, in high-risk older adults after hospitalization.
