To assess the daytime effects of insomnia pharmacotherapy using different measurement methods, specifically comparing traditional questionnaires with smartphone-based ecological momentary assessment (EMA) to capture nuanced effects.
Key Findings:
Suvorexant reduced insomnia severity compared to placebo according to traditional questionnaires.
EMA revealed significant time-of-day-specific changes in fatigue and cognition not detected by standard questionnaires.
Participants reported greater morning fatigue and reduced alertness earlier in the day with suvorexant, but lower fatigue and sleepiness later in the afternoon and evening.
High completion rates of EMA surveys indicated feasibility in tracking symptoms in older adults.
Findings may have implications for clinicians in evaluating patient response to treatment.
Interpretation:
Reliance on retrospective questionnaires may obscure clinically relevant daytime effects of insomnia treatment, suggesting a need for more nuanced evaluation methods, particularly through EMA.
Limitations:
Small sample size and short duration of the study may limit the generalizability of findings.
Findings regarding mood differences were not statistically significant, indicating caution in interpretation.
Conclusion:
EMA could enhance outcome measurement in insomnia research and clinical care, supporting more patient-centered treatment decisions and improving the evaluation of insomnia therapies.
In a target-trial emulation of more than 600,000 veterans, GLP-1 RA initiators saw fewer new substance use disorders—and patients with existing SUDs had fewer overdoses, hospitalizations, and deaths.
