Real-world experience with daridorexant for insomnia in adults with intellectual disabilities: a retrospective single-centre case series.

Chronic insomnia is common in adults with intellectual disabilities, yet evidence to guide pharmacological management is limited. We report a real-world case series of five adults with intellectual disabilities and multimorbidity treated with daridorexant, a dual orexin receptor antagonist approved in Europe for insomnia. Daridorexant was associated with marked improvements in sleep quality and quantity, despite complex comorbid sleep, physical, mental and neurodevelopmental disorders. Subject to the limitations of a small, uncontrolled case series, these gains were associated with other reported improvements, including a reduction in challenging behaviours, improved daytime functioning and substantial alleviation of parent and carer burden.