Lemborexant Shift Work Treatment Study

NCT ID: NCT05344443

Last Updated: 2026-02-04

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 29 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-03-10
• Study Completion Date: 2024-11-30

Brief Summary

Insomnia and daytime sleepiness are common complaints among night shift workers, but effective sleep treatments in shift workers are lacking. The aim of this Phase IV double-blind, placebo-controlled, randomized study is to test whether a dual orexin antagonist, Lemborexant (5mg or 10mg), which would be expected to block the clock-driven orexin-mediated wakefulness during the day, will increase daytime sleep time in shift workers who complain of difficulty sleeping during the daytime compared to placebo.

Detailed Description

Insomnia and daytime sleepiness are common complaints among night shift workers. A meta-analysis on sleep in shift workers indicates that fixed night shift workers sleep, on average, 0.4 hours less than fixed day shift workers, while rotating shift workers sleep on average 1 hour less than fixed day shift workers. While there may be several reasons for sleep difficulties and sleep loss among shift workers, the misalignment of one's sleep preference (i.e., goal of sleeping during the day) and one's circadian rhythm (i.e., endogenous rhythm that signals the body to be awake during the day) is thought to be a primary cause. Insufficient sleep among night shift and rotating shift workers is linked with significant health consequences, including elevated risk for cardiovascular disease and cancer. Effective sleep treatments in shift workers are lacking. However, a recent randomized study of Suvorexant (20mg), a hypocretin/orexin receptor antagonist, produced a significant improvement in daytime total sleep time compared to placebo. Available evidence suggests that the reason Suvorexant is effective is because it blocks the hypocretin/orexin receptors that mediate signaling from the biological clock (suprachiasmatic nucleus of the hypothalamus) attempting to maintain sustained wakefulness during the biological day. As Lemborexant is also a hypocretin/orexin antagonist, it would also be expected to improve daytime sleep in shift workers but would have the advantage over Suvorexant of being highly effective in the dosages available for clinical use. As such, Lemborexant is ideally positioned to be an effective and important treatment of sleep problems in shift workers.

The aim of this Phase IV double-blind, placebo-controlled, randomized study is to test whether a dual orexin antagonist, Lemborexant (5mg or 10mg), which would be expected to block the clock-driven orexin-mediated wakefulness during the day, will increase daytime sleep time in shift workers who complain of difficulty sleeping during the daytime compared to placebo.

This will be a 4-week double blinded placebo controlled trial (2 weeks of baseline assessment followed by 2-weeks of treatment/placebo). The trial design is based on a recent successful study of the treatment of sleep problems in shift workers with a hypocretin/orexin receptor antagonist.

Conditions

Shift-Work Related Sleep Disturbance

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

Active Treatment

Participants randomized into this arm will receive Lemborexant (5-10mg).

Group Type: EXPERIMENTAL

Lemborexant

Intervention Type: DRUG

A dual orexin antagonist

Placebo Treatment

Participants randomized into this arm will receive a placebo medication which appears the same as the active treatment.

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

A placebo that looks and tastes like Lemborexant tablets

Interventions

Lemborexant

A dual orexin antagonist

Intervention Type: DRUG

Placebo

A placebo that looks and tastes like Lemborexant tablets

Intervention Type: DRUG

Other Intervention Names

Dayvigo

Eligibility Criteria

Inclusion Criteria

• Full-time night shift work (at least 6 hours per shift, 4 days per week or 32 hours per week)
• Employed as a night shift worker for at least 3 months
• Self-reported concerns about daytime sleepiness and difficulty sleeping during the daytime

Exclusion Criteria

• Pregnancy (verified by urine pregnancy test) or plan to become pregnant in the next 3 months
• Currently breastfeeding
• Inadequate opportunity for sleep during the daytime (< 7 hours opportunity) after overnight shift
• Extreme circadian preference (based on Horne & Ostberg Morningness-Eveningness Questionnaire)
• Severe depressive symptoms (>25 on CES-D)
• Unwillingness to discontinue sleep aids (prescription or non-prescription) during the study period
• Presence of sleep disordered breathing (verified by Apnea link)
• Self-reported diagnosis of narcolepsy, restless legs syndrome
• Self-reported intake of >600mg of caffeine per night shift or use of stimulants during night shift, rotational, or irregular shifts
• Unstable or untreated medical or psychiatric condition based on clinical interview.
• Severe hepatic or renal impairment (based on chemistry panel);
• Self-reported use of digoxin or strong or moderate cytochrome P450 3A4 isozyme inhibitors or cytochrome P450 3A4 isozyme inducers for 6 months prior to or during the study

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of California, San Francisco

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Aric Prather, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

University of California, San Francisco

San Francisco, California, United States

Countries

United States

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

http://tinyurl.com/UCSFShiftStudy

Study Screener

Other Identifiers

20-32763

Identifier Type: -

Identifier Source: org_study_id