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Sleep cycle disturbance and insomnia
Having severe form of CFS , neuropathy and insomnia since 5 years.
My sleep is completely disturbed. Difficult falling a sleep and also difficult staying a sleep.
One of my doctor advice zolpidem 10 mg and other doctor advice dayvigo 10 .
Which is better in terms of safty and next day hangover ?
Answers (9)
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Hi, Thanks for reaching out!
Both Dayvigo (lemborexant) 10 mg and Zolpidem 10 mg are indicated for the management of insomnia, but their safety profiles and risk of next-day hangover differ significantly. Evidence from randomized controlled trials and meta-analyses indicates that lemborexant (Dayvigo) is associated with a lower risk of next-day residual sedation, psychomotor impairment, and falls, compared to zolpidem.
Next Steps
a. Close follow-up with the treating physician to monitor efficacy, tolerability, and any adverse effects.
b. Behavioral strategies and sleep hygiene should be optimized alongside medication, and if symptoms persist beyond 7-10 days, re-evaluation for underlying factors or alternative therapies- including cognitive behavioral therapy for insomnia (CBT-I)- is recommended.
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Health Tips
- Routine medication review, proper supervision, and regular assessment of fall risk and cognitive status are key in management, particularly for those with comorbid medical conditions.
- Avoid watching Mobile phones during sleep initiation.
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Both zolpidem (10 mg) and Dayvigo / lemborexant (10 mg) are prescription sleep medications but belong to different classes. Zolpidem is a short-acting hypnotic (often used for sleep initiation), while Dayvigo is an orexin receptor antagonist (used for both sleep initiation and maintenance). The choice depends on your main problem â falling asleep, staying asleep, or both.
Next Steps
Since two doctors have given different advice, itâs best to ask one of them to clearly explain why they chose that option based on your specific case, medical history, and other medications. If sleep maintenance (staying asleep) is your bigger issue, Dayvigo is often considered safer for long-term use. If quick sleep onset is your problem, zolpidem may help, but it has higher risks of dependence and next-day grogginess if not carefully dosed.
Health Tips
In terms of safety and next-day hangover, studies suggest Dayvigo has a lower risk of morning grogginess, memory issues, or dependence compared to zolpidem. Zolpidem can sometimes cause sleepwalking, confusion, or rebound insomnia if stopped suddenly, especially with long-term use. Good sleep hygiene practices (fixed sleep schedule, no screens 1 hr before bed, dark cool room, relaxation before sleep) should continue alongside any medication.
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As per my opinion, zolpidem is a better choice
* Symptoms that you have mentioned, along with zolpidem other medication too required for treating root cause*
For example, the pain that you have mentioned, the mood and thought process during disturbed sleep, mood symptoms during the day, these symptoms need more evaluation
Other factor is other comorbity as HTN., DM, THYROID etc,baseline assessment for weight too
Any stress ongoing need to be assessed
Some life style modifications as
Avoid caffeine rich diet as tea ,coffee
Avoid smoking, alcohol
Try to opt for relaxation exercise as yoga ,aid in sound sleep
Dinner before 8
Reduce screen use
You can read on net regarding sleep hygiene
You must discuss these points and query with the doctor
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I understand how draining this feels. Between the two, Dayvigo (lemborexant) tends to have fewer next-day hangover effects and is considered safer for longer use than Zolpidem. But your unique health history matters please discuss closely with your sleep doctor before deciding.
Next Steps
First, stabilise your sleep routine same bedtime, no screens before bed, calming wind-down.
Second, gently pace activity during the day to avoid overexertion.
Third, track triggers in a sleep diary.
Finally, combine with relaxation skills breathing, grounding, gentle body scan.
And keep regular check-ins with your doctor so medication and therapy support each other.
Health Tips
Keep lights dim an hour before bed, avoid caffeine after noon, use bed only for sleep not worry.
If you can’t fall asleep in 20 minutes, get up and do something calming until drowsy.
Try gentle stretches or warm shower before bed.
Anchor your day with small routines morning light exposure, regular meals.
Most important is to be kind to yourself; poor sleep isn’t your fault.
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Hi.. consult online for treatment
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Dr. K L Tejaswini
Neuropsychiatrist
7 yrs exp
Guntur
Hii..
Zolpidem and dayvigo both act on different pathways..
Zolpidem can be useful for short term use and cause sleep initiation.. whereas dayvigo can be used in the long run with less side effects and addiction potential than zolpidem
Consult online for further assessment and treatment
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Dr. Pavitra Shankar
Psychiatrist
5 yrs exp
New Delhi
Both Zolpidem (10 mg) and Dayvigo (Lemborexant 10 mg) are approved for insomnia.
• Zolpidem acts quickly and is usually effective for initiating sleep, but in some patients it can cause next-day grogginess, memory issues, or even dependence if used long term.
• Dayvigo belongs to a newer class (orexin receptor antagonists). It is considered relatively safer for long-term use, with less risk of dependence, and many patients report lower chances of next-day hangover. However, it may take a few days to show full benefit.
Next Steps
• Choice of medication depends on whether your main difficulty is falling asleep (zolpidem often helps more) or staying asleep (Dayvigo may be better).
• Discuss with your treating doctor if a sleep study or review of other causes (neuropathy, CFS, pain, mood) is warranted, since treating the root cause often improves sleep.
• Good sleep hygiene (fixed sleep schedule, reduced screen use before bedtime, relaxation practices) should go hand in hand with medication.
Health Tips
Caution / Helpful Tips:
• Avoid self-adjusting dose or taking both medicines together.
• Use the lowest effective dose for the shortest duration needed.
• Monitor for any unusual side effects like excessive daytime drowsiness, imbalance, or confusion.
• Long-term reliance on only sleep medicines is not ideal — combining with behavioural therapy for insomnia (CBT-I) gives best results.
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