{
  "abstract": "Introduction: Chronic insomnia is a prevalent 24-hour disorder with significant daytime impact. Its management is frequently complicated by conceptual barriers, limited use of standardised diagnostic tools and prolonged benzodiazepine use, while insomnia is often overlooked or inadequately coded as an independent disorder. These challenges highlight the need for improved recognition and clearer therapeutic pathways. Dual orexin receptor antagonists (DORAs), particularly daridorexant, offer a new pharmacological option targeting wake-promoting pathways, yet practical guidance on their clinical use remains limited.\n\nMethod: A multidisciplinary panel of seven experts conducted a national consensus using the RAND/UCLA Appropriateness Method. Seventy-four statements addressing the nature, diagnosis and treatment of chronic insomnia, including the clinical use of daridorexant, were evaluated across two rating rounds and a structured discussion. Consensus was reached on 36 statements in round one; one statement was removed; and the remaining 37 achieved consensus in round two.\n\nResults: Experts agreed that chronic insomnia is a distinct disorder, with hyperarousal as a central mechanism, and emphasised the importance of targeting daytime functioning and preserving sleep architecture. Daridorexant was considered appropriate across heterogeneous clinical profiles, supported by evidence demonstrating improvements in nocturnal sleep, daytime functioning and sleep architecture, along with favourable tolerability and low abuse potential.\n\nConclusions: This consensus supports a pragmatic and patient-centred approach to chronic insomnia management, integrating current evidence with expert clinical experience. The recommendations may help guide decision-making in routine practice, including the use of daridorexant when pharmacological treatment is considered appropriate.",
  "abstract_shown": true,
  "affiliations": [
    "Neuroscience, Sleep Disorders, Bioaraba Health Research Institute",
    "Osakidetza Basque Health Service, Araba University Hospital",
    "Primary Care, Centro de Salud Islas Canarias",
    "Spanish Society of General and Family Physicians (SEMG)",
    "Occupational Risk Prevention Department. General University Hospital of Castellón",
    "Spanish Association of Occupational Medicine",
    "Codirector of Sleep Unit, Neurology Service, Ruber International Hospital",
    "Neurology Service, Getafe University Hospital",
    "Service of Psychiatry And Mental Health, University Hospital Doctor Peset",
    "Service of Neurology, University Hospital Marqués de Valdecilla, Universidad de Cantabria and IDIVAL",
    "Senior Psychiatrist, Miembro del CIBERSAM, Colegio de Psiquiatras Eméritos de la Sociedad Española de Psiquiatría y Salud Mental"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Ainhoa Álvarez-Ruiz-Larrinaga"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Lorenzo Armenteros"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Carmen Bellido"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Laura Lillo Triguero"
    },
    {
      "affs": [
        8
      ],
      "name": "José Martínez-Raga"
    },
    {
      "affs": [
        9
      ],
      "name": "Julio Pascual"
    },
    {
      "affs": [
        10
      ],
      "name": "Luis San"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5z0wbqd54gwtf.bib",
  "cited_by": 0,
  "doi": "10.3389/fpsyt.2026.1927424",
  "fulltext_url": "https://europepmc.org/articles/PMC13710333",
  "id": "5z0wbqd54gwtf",
  "issns": [
    "1664-0640"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1927424/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "3205|Sleep and related disorders"
    ]
  ],
  "openalex": "W7221685268",
  "pdf_url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2026.1927424/pdf",
  "pmcid": "PMC13710333",
  "pmid": "42948062",
  "published": "2026-10-13",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5z0wbqd54gwtf.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:18Z",
      "native_id": "10.3389/fpsyt.2026.1927424",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1927424/full"
    },
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42948062",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948062"
    },
    {
      "first_seen": "2026-10-31T12:21:19Z",
      "native_id": "PMC13710333",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpsyt.2026.1927424"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1664-0640",
      "subfield": "psychiatry"
    }
  ],
  "title": "Comprehensive management of chronic insomnia in Spain: a multidisciplinary modified RAND/UCLA consensus with recommendations on daridorexant",
  "title_text": "Comprehensive management of chronic insomnia in Spain: a multidisciplinary modified RAND/UCLA consensus with recommendations on daridorexant",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:19Z",
  "url": "https://research.draconitic.com/paper/5z0wbqd54gwtf",
  "venue": "Frontiers in Psychiatry",
  "versions": []
}