Efficacy of CBT-I and Lemborexant Medication for Different Subtypes of Chronic Insomnia

Exclusion Criteria

• •Presence of a lifetime diagnosis of any psychotic or bipolar disorder
• •Untreated psychiatric disorder (e.g., major depression) or risk for suicide
• •Substance/alcohol use disorder within the past year
• •Any life-threatening or progressive medical illness (e.g., cancer, chronic obstructive pulmonary disease) or neurological degenerative disease (e.g., dementia)
• •Current use of sleep-promoting medications (prescribed or over-the-counter) or cannabis-derived products for sleep more than two nights per week
• •Current use of tricyclic antidepressants, monoamine oxidase inhibitors, or atypical antidepressants
• •Reported diagnosis of sleep disorder other than insomnia (e.g., obstructive sleep apnea, restless legs syndrome, rapid eye movement behavior disorder, delayed phase sleep disorder, narcolepsy)
• •Total score \> 5 on the Stop-Bang Questionnaire and/or clinical symptoms suggestive of sleep apnea (excessive daytime sleepiness), or Epworth score \> 10, restless legs syndrome or other signs of other sleep disorders
• •Atypical sleep schedules (i.e., habitual bedtimes later than 2:00 AM and rising times later than 10:00 AM on more than two days/nights per week as documented from a sleep diary)
• •Working night shifts more than five nights per month in the last six months
• •Consuming 2 or more alcoholic beverages per day regularly (3 days or more per week)
• •Any contra-indications to using the study medication, including lung disease/breathing problems (e.g., chronic obstructive pulmonary disease), use of strong or moderate CYP3A inducers (strong - rifampin, carbamazepine, and St. John's Wort) (moderate - bosentan, efavirenz, etravirine, and modafinil), pregnant and breastfeeding women
• •Not using any method of birth control