What are the differences in the mechanisms of action between traditional sleeping pills and new-generation sleeping aids such as Suvorexant?

1. Why can traditional sleeping pills no longer meet modern sleep needs?

Insomnia has become a global health problem. More than 35% of adults have varying degrees of sleep disorders , of which 10% suffer from chronic insomnia ( Morin et al., 2020 ). For people with long-term insomnia, sleep aids have become an important tool for improving sleep quality. However, many people who take traditional sleeping pills (such as diazepam and zopiclone) find that although they can help them fall asleep, long-term use brings problems such as addiction risk, morning drowsiness, and decreased attention .

This has prompted the medical community to continue to look for safer ways to help you sleep . In recent years, new-generation sleeping aids such as Suvorexant are becoming more recommended by doctors due to their non-addictive and non-affective properties for deep sleep . So, what are the differences in the mechanisms of action of these two types of drugs? Why are more and more patients turning to new sleeping aids?

 

2. How traditional sleeping pills work and their side effects

Benzodiazepines (such as diazepam, alprazolam) and non-benzodiazepines (such as zopiclone, zolpidem) are the most common sleep aids in the past few decades. Their mechanism of action is to enhance the inhibitory effect of GABA ( gamma -aminobutyric acid) receptors and help people fall asleep by calming the nervous system .

📌 The main problems with traditional sleeping pills :

1. It is easy to become addicted. Long-term use may lead to tolerance - the user needs to gradually increase the dose to maintain the effect, and more severe insomnia may occur after stopping the drug ( Lader, 2011 ).

2. Affects deep sleep - Although it can help you fall asleep, it may inhibit rapid eye movement ( REM ) sleep and affect memory consolidation and brain repair ( Kuriyama & Endo, 2018 ).

3. Feeling sleepy when waking up in the morning affects daytime wakefulness - Since some drugs have a long half-life, they may cause drowsiness and decreased concentration the next day, and even increase the risk of traffic accidents ( Billioti de Gage et al., 2014 ).

Research data shows that :

•       Long-term use of benzodiazepines increases the risk of Alzheimer's disease by 50% ( Billioti de Gage et al., 2014 ).

•       Patients taking non-benzodiazepines such as zopiclone have a 30% increased risk of morning sleepiness , which affects daily activities ( Kuriyama & Endo, 2018 ).

These side effects make traditional sleeping pills unsuitable as a long-term sleep aid .

 

3. How do new generation sleeping aids such as Suvorexant help the brain fall asleep naturally?

The new generation of sleeping aids such as Suvorexant, Lebrexant, and Darilexant are orexin receptor antagonists ( ORA ) , and their mechanism of action is completely different from traditional sleeping pills .

Orexin : The neurotransmitter that maintains wakefulness

•       During the day : Orexin levels are higher, helping to maintain wakefulness and concentration.

•       Night : Normally, orexin levels drop, sending the brain into rest mode.

•       Insomniacs : Due to the overactivity of orexin, the brain cannot enter the sleep state smoothly.

📌 Mechanism of action of new sleep aids (orexin receptor antagonists) :

•       Reduces wakefulness signals without forcing sedation - Unlike traditional sleeping pills that suppress nerves, it allows the brain to fall asleep naturally.

•       Maintains natural sleep structure - does not disrupt deep sleep and improves sleep repair function.

•       It is non-addictive and can be used for a long time - long-term use will not produce tolerance, and no withdrawal symptoms will occur after stopping the drug ( Sun et al., 2021 ).

 

4. The difference between traditional sleeping pills and new sleeping pills

Features	Traditional sleeping pills (eg, diazepam, zopiclone)	Newer sleep aids (such as suvorexant, lebrexant, darilexant)
Mechanism of action	Acts on GABA receptors to directly calm the nervous system	Acts on orexin receptors to reduce wakefulness signals and allow the brain to fall asleep naturally
Is it addictive?	Long-term use can lead to addiction and increased tolerance	No dependency, can be used for a long time
Does it affect deep sleep?	May reduce REM sleep and affect memory consolidation	Does not affect deep sleep and improves sleep quality
Morning state	Morning drowsiness and decreased concentration	Wake up in the morning without any effects

📌 Research data shows that :

•       Patients taking suvorexant experienced 43% fewer nighttime awakenings and more stable sleep ( Herring et al., 2016 ).

•       Dauvilliers can increase the proportion of deep sleep without affecting daytime wakefulness ( Dauvilliers et al., 2022 ).

•       Clinical trials of Lebrexant showed that there was no tolerance after 6 months of continuous use, and sleep remained stable after discontinuation of the drug ( Ueno et al., 2022 ).

 

5.How to choose the sleeping pills that suit you?

If your insomnia is a short-term anxiety-induced sleep disorder , traditional sleeping pills may be effective, but be careful to avoid long-term use .

If your insomnia is characterized by long-term difficulty falling asleep, waking up easily at night, and fatigue in the morning , then new sleeping aids such as Suvorexant may be a more scientific and safer choice .

📌 Recommended dosage and usage suggestions :

•       Suvorexant ( 10-20mg ) - suitable for those who wake up easily at night and help maintain a full night's sleep .

•       Lebrexan ( 5-10mg ) - suitable for difficulty falling asleep, helping the brain enter sleep mode faster .

•       Dali Lexan ( 25mg ) - Suitable for shallow sleep, morning fatigue, and helps improve deep sleep .

 

6. Conclusion: Why are new sleeping aids replacing traditional sleeping pills?

Although traditional sleeping pills can help you fall asleep, long-term use can easily lead to addiction and may affect deep sleep and cognitive function .

In contrast, new sleeping aids such as suvorexant, leporexant, and darilexant reduce wakefulness signals, allowing the brain to fall asleep naturally. They are not addictive and do not affect memory and daytime state , making them safer long-term sleep aid options .

If you want to choose a safer and more scientific way to help you sleep , these new sleeping pills may be your best choice.

 

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