The last day of operation for Hertfordshire and West Essex ICB was 31 March 2026. The information on this website has not been updated since 31 March 2026. The legacy policies, prescribing recommendations and pathways can be accessed on this website. Find out more

Indication
Insomnia
RAG rating
Green
Document type
NICE technology appraisal
Place
Hertfordshire and West Essex ICB
Output type
Pharmacy / Prescribing

Daridorexant

Daridorexant

NICE Technology Appraisal 922 recommends daridorexant as an option for treating insomnia in adults with symptoms lasting for 3 nights or more per week for at least 3 months, and whose daytime functioning is considerably affected, only if:

  • cognitive behavioural therapy for insomnia (CBTi) has been tried but not worked, or
  • CBTi is not available or is unsuitable*.

Before considering daridorexant ensure:

  • Any circumstances/stressors associated with onset of insomnia have been addressed
  • Insomnia related to other conditions such as sleep apnoea, restless legs have been explored
  • Information has been provided to patients on insomnia and sleep hygiene - Prescribers should refer to NICE Clinical Knowledge Summary on insomnia for further information about the assessment, diagnosis, and management of insomnia.
  • Sleep hygiene measures have been implemented and failed
  • Patients are asked to keep a sleep diary to help identify what is keeping them awake. This is a useful tool which will help to pinpoint if there are any patterns affecting sleep. This is best completed over a two-week period and can be used as evidence of patient’s sleep-wake pattern which can help with diagnosis. An example can be found here sleepdiary.pdf (www.nhs.uk)
  • Digital CBTI has been tried

The length of treatment should be as short as possible. Treatment with daridorexant should be assessed within 3 months of starting and should be stopped in people whose long-term insomnia has not responded adequately. If treatment is continued, assessment should be undertaken to determine whether it is still working at regular intervals.

*Support for insomnia including Cognitive Behavioural therapy for Insomnia – CBT-I

 

To access help for sleeping problems alongside concerns about  mental wellbeing, people aged 16 or over who are registered with a GP in Hertfordshire and West Essex can self-refer for support, including CBTi via NHS Talking Therapies.

 

People in Hertfordshire can self-refer and access support including self-help guides and videos via:  https://www.hpft-talkingtherapies.nhs.uk/.  GPs and other healthcare professionals can also refer someone to the service directly by using the clinical referral form. 

 

People in West Essex can self-refer and access support via: https://www.vitahealthgroup.co.uk/nhs-services/nhs-mental-health/west-essex/ .  GPs and other healthcare professionals can also refer someone to the service directly by using the referral link on this website.

 

The referral information will be reviewed, and service users will then be contacted to arrange an assessment to discuss their needs and identify the most appropriate support.

Locally developed resources are available on the website:

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