Supplements

Lemborexant improves sleep quality in patients with cirrhosis

In a double-blind, placebo-controlled crossover trial, Lemborexant at 5 mg and 10 mg significantly reduced Pittsburgh Sleep Quality Index (PSQI) scores in cirrhosis patients over 2 weeks. The 5 mg dose also improved cognitive function as measured by the EncephalApp Stroop Test, while the 10 mg dose showed a mild increase in reaction time. Liver function remained unchanged across groups.

Last updated: Jul 11, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Clinical Trial: Lemborexant Efficacy and Safety in Liver Cirrhosis-Randomized, Double-Blind, Crossover Clinical Trial.

observational

Gani RA, Akbar P, Hasan I, Sulaiman AS, Lesmana CRA, Kurniawan J, Panjaitan SM, Dirjayanto VJ · Alimentary pharmacology & therapeutics (2026)

Participants: N/A
Duration: 2 weeks (plus 2-week crossover phase)
Intervention: Lemborexant 5 mg or 10 mg taken before bed for 2 weeks
Outcome: Sleep quality measured by Pittsburgh Sleep Quality Index (PSQI) and cognitive function via EncephalApp Stroop Test reaction time
Effect Size: PSQI mean difference: 5 mg MD -7.0 ± 3.15 (p<0.001); 10 mg MD -8.27 ± 2.68 (p<0.001)
Population: Patients with cirrhosis (n=82) from Cipto Mangunkusumo National Referral Hospital

Result:

PubMed: 42414855DOI: 10.1111/apt.70811

Mechanism Graph

Lemborexant binds to orexin receptors OX1R and OX2R
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Antagonizes orexin-mediated wakefulness
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Promotes sleep initiation and maintenance
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Result: Improved sleep quality and reduced PSQI scores

Limitations

  • ⚠Short 2-week treatment period limits assessment of long-term efficacy and safety
  • ⚠Single-center study may reduce generalizability to broader cirrhosis populations

Frequently Asked Questions

Is Lemborexant safe for patients with liver cirrhosis?▼

The study found no significant changes in liver function tests (AST, ALT, total bilirubin) across treatment groups, suggesting short-term safety. However, the 10 mg dose was associated with a mild increase in Stroop Test reaction time, indicating possible cognitive effects.

What dose of Lemborexant is recommended for sleep problems in cirrhosis?▼

The study supports 5 mg as the preferred dose, as it improved sleep quality and cognitive function, while 10 mg showed a mild negative effect on reaction time.

Does Lemborexant cause rebound insomnia after stopping?▼

Post-crossover analysis showed persistent low PSQI scores in active groups switched to placebo, suggesting no significant rebound insomnia within the study period.

How does Lemborexant compare to other insomnia treatments for cirrhosis?▼

This is the first controlled trial of Lemborexant in cirrhosis, showing efficacy and safety. No direct comparisons with other treatments were made in this study.

Products

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References

  1. 1.Gani RA, Akbar P, Hasan I, Sulaiman AS, Lesmana CRA, Kurniawan J, Panjaitan SM, Dirjayanto VJ. "Clinical Trial: Lemborexant Efficacy and Safety in Liver Cirrhosis-Randomized, Double-Blind, Crossover Clinical Trial.." Alimentary pharmacology &amp; therapeutics, 2026. PMID: 42414855 DOI: 10.1111/apt.70811
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.