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QUVIVIQ™ is indicated for the treatment of adult patients with insomnia characterised by symptoms present for at least 3 months and considerable impact on daytime functioning.1
The burden of chronic insomnia
What is chronic insomnia?
Chronic insomnia is a distinct disorder that impacts a patient’s nights and days,5 defined by encompassing three categories:
- getting to sleep
- maintaining sleep
- early awakening
- non-restorative sleep
despite adequate opportunity for sleep…5
- impacted cognitive functioning6,7
- increased daytime fatigue7,8
- increased risk of mood disorders7,8
Symptoms occurring ≥3 nights per week for at least 3 months5
Chronic insomnia
Internationally recognised classification systems categorise chronic insomnia as a distinct condition that should be addressed separately from other sleep disorders.9
The burden of chronic insomnia
- Approximately one-third of adults are predicted to be affected by insomnia symptoms during their lives10
- Recovery is slow, with 38% of patients still affected by insomnia after 5 years11
of adults suffer from insomnia symptoms10
are predicted to have chronic insomnia10
*Data in paediatric populations are limited. This study was based on an adolescent cohort in Michigan, US.12
Ageing is associated with changes in sleep patterns.13
- Less time in deep (slow wave) sleep
- More frequent and prolonged nocturnal awakenings
- More time spent awake during the night
Hormonal fluctuations, particularly during menstrual cycles, pregnancy and menopause, can contribute to sleep disturbances in women.14
Depression and anxiety affect daytime sleepiness, general sleep quality and insomnia severity, especially when both conditions are present simultaneously.15
A plethora of conditions are associated with insufficient sleep, including coronary artery disease, diabetes, obesity, dementia, impaired immune responses, asthma and COPD.16,17
Stimulants that may cause sleep disruption include SSRIs, decongestants, bronchodilators, some antihypertensives, sympathomimetics, anticholinergics, H2 antagonists and corticosteroids.18
Irregular sleep schedules, inconsistent bedtime routines and excessive use of electronic devices prior to sleep may contribute to poor sleep.19,20
Short- and long-term consequences of chronic insomnia
Direct impacts of chronic insomnia on patients include:8,21-26
- Fatigue8
Low mood
Reduced ability to cope with stress
Cognitive impairment
Behavioural issues in children/ adolescents
Increased risk of falls in the elderly
Increased risk of home, work and car accidents
Comorbidity risk
Chronic insomnia can also increase the risk of comorbidities, including:
Cardiometabolic27
Obesity
Diabetes mellitus
Coronary heart disease
Hypertension
Psychological/ psychiatric17
Major depression
Anxiety disorders
Suicide
Post-traumatic stress disorder
Bipolar depression
Substance misuse
Neurological28,29
Alzheimer’s disease/ dementia
Headache/ migraine
Immunological30
Lowered immunity
Impaired response to vaccinations
COVID-19
Impact of insomnia on QoL
Studies using the SF-36 to assess insomnia and its impact on QoL showed that individuals with insomnia reported significantly worse QoL compared with those with good sleep patterns.31
These impairments are not simply limited to obvious domains, like vitality and energy, but extend to a patient’s mental wellbeing, interpersonal relationships, recreational pursuits, work and overall QoL.31
are 3.5x more likely to have a fatal motor vehicle injury vs people without chronic insomnia32
miss 2x as many work days vs people without chronic insomnia33
Economic impact of insomnia
Chronic insomnia has substantial economic costs related to its negative effects on health, wellbeing, safety and productivity. It affects patient health, the wider healthcare system and the economy of every country across the globe.10
~ £33 billion† or 1.3% GDP estimated annual loss in the UK
associated with lost productivity due to chronic insomnia10
†Calculated from estimated US $41.4 billion,10 based on Bank of England exchange rate of 1.2708 as of 5th December 2024.
Annual hidden costs of insomnia in the UK10
Each person with chronic insomnia experiences around:
11-18 days
of absence from work
39-45 days
of presenteeism‡
44-54 days
of overall productivity loss
A loss of £1 in every £76 of national wealth
‡Presenteeism in this context refers to employees going to work when well but not fully functioning.10
This medicine is subject to additional monitoring.
Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/. Adverse events should also be reported to Idorsia at ds.safety.uk@idorsia.com.
This information is intended for UK healthcare professionals.
References
- QUVIVIQ™ (daridorexant) Summary of Product Characteristics
- Mignot E, Mayleben D et al. Safety and efficacy of daridorexant in patients with insomnia disorder: results from two multicentre, randomised, double-blind, placebo-controlled, phase 3 trials. Lancet Neurol 2022;21:125-139
- Robbins R, Quan S F et al. A nationally representative survey assessing restorative sleep in US adults. Front Sleep 2022;1:935228
- Kunz D, Dauvilliers Y et al. Long-term safety and tolerability of daridorexant in patients with insomnia disorder. CNS Drugs 2023;37:93-106
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Arlington, VA, American Psychiatric Publishing, 2022
- Ustinov Y, Lichstein K L et al. Association between report of insomnia and daytime functioning. Sleep Med 2010;11:65-68
- Kyle S D, Espie C A, Morgan K. “…Not just a minor thing, it is something major, which stops you from functioning daily”: quality of life and daytime functioning in insomnia. Behav Sleep Med 2010;8:123-140
- Shekleton J A, Flynn-Evans E E et al. Neurobehavioral performance impairment in insomnia: relationships with self‑reported sleep and daytime functioning. Sleep 2014;37:107-116
- Riemann D, Espie C A et al. The European Insomnia Guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res 2023;32:e14035
- Hafner M, Romanelli R J et al. The societal and economic burden of insomnia in adults: an international study. RAND Corporation, Santa Monica, CA, US, 2023. Available at: rand.org. Accessed July 2025
- Morin C M, Jarrin D C et al. Incidence, persistence, and remission rates of insomnia over 5 years. JAMA Netw Open 2020;3:e2018782
- Johnson E O, Roth T et al. Epidemiology of DSM-IV insomnia in adolescence: lifetime prevalence, chronicity, and an emergent gender difference. Pediatrics 2006;117:e247-256
- Li J, Vitiello M V, Gooneratne N S. Sleep in normal aging. Sleep Med Clin 2018;13:1-11
- Nowakowski S, Meers J, Heimbach E. Sleep and women’s health. Sleep Med Res 2013;4:1-22
- Oh C M, Kim H Y et al. The effect of anxiety and depression on sleep quality of individuals with high risk for insomnia: a population-based study. Front Neurol 2019;10:849
- Ezzie M E, Parsons J P, Mastronarde J G. Sleep and obstructive lung diseases. Sleep Med Clin 2008;3:505-515
- Lim D C, Najafi A et al. The need to promote sleep health in public health agendas across the globe. Lancet Public Health 2023;8:e820-e826
- Neubauer D N. Sleep problems in the elderly. Am Fam Physician 1999;59:2551-2558, 2559-2560
- Kang J H, Chen S C. Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan. BMC Public Health 2009;9:248
- Pham H T, Chuang H L et al. Electronic device use before bedtime and sleep quality among university students. Healthcare (Basel) 2021;9:1091
- Babson K A, Trainor C D et al. A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms: an experimental extension. J Behav Ther Exp Psychiatry 2010;41:297-303
- Dinges D F, Pack F et al. Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night. Sleep 1997;20:267-277
- Astill R G, Van der Heijden K B et al. Sleep, cognition, and behavioral problems in school-age children: a century of research meta-analyzed. Psychol Bull 2012;138:1109-1138
- Chen T Y, Lee S, Buxton O M. A greater extent of insomnia symptoms and physician-recommended sleep medication use predict fall risk in community-dwelling older adults. Sleep 2017;40. doi:10.1093/sleep/zsx142
- Centers for Disease Control and Prevention (CDC). Facts about falls. May 2023. Available at: cdc.gov. Accessed July 2025
- Léger D, Bayon V et al. Insomnia and accidents: cross-sectional study (EQUINOX) on sleep-related home, work and car accidents in 5293 subjects with insomnia from 10 countries. J Sleep Res 2014;23:143-152
- Itani O, Jike M et al. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med 2017;32:246-256
- Robbins R, Quan S F et al. Examining sleep deficiency and disturbance and their risk for incident dementia and all-cause mortality in older adults across 5 years in the United States. Aging (Albany NY) 2021;13:3254-3268
- Fernández-de-Las-Peñas C, Fernández-Muñoz J J et al. Sleep disturbances in tension-type headache and migraine. Ther Adv Neurol Disord 2018;11:1756285617745444
- Schmitz N C M, van der Werf Y D, Lammers-van der Holst H M. The importance of sleep and circadian rhythms for vaccination success and susceptibility to viral infections. Clocks Sleep 2022;4:66-79
- Ishak W W, Bagot K et al. Quality of life in patients suffering from insomnia. Innov Clin Neurosci 2012;9:13-26
- Laugsand L E, Strand L B et al. Insomnia symptoms and risk for unintentional fatal injuries – the HUNT study. Sleep 2014;37:1777-1786
- Léger D, Guilleminault C et al. Medical and socio-professional impact of insomnia. Sleep 2002;25:625-629
© NICE 2023. Daridorexant for treating long-term insomnia. Available from www.nice.org.uk/guidance/TA922. All rights reserved. Subject to Notice of rights.
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/ publication.
UK-DA-00914 | Last updated: July 2025
QUV-Pro.idorsia QUVIVIQ Burden of chronic insomnia_June 2025
