Not Satisfactory
The following paragraph is a confusing, convoluted presentation of numbers:
“At the outset, when patients spent eight hours in bed, they were typically asleep for 66 percent of that time. One day on suvorexant boosted that by anywhere from 5 percent to 13 percent, relative to the placebo. Between 21 and 37 fewer minutes were spent awake during those sleep periods.”
First, percentages of time asleep were used, then minutes of wakefulness. So the descriptors are switched, leaving readers like us losing sleep.
Suggestions:
- Don’t make readers do the math. Instead of saying people were typically asleep for 66% of 8 hours in bed, tell them that means a little more than 5 hours. Most of us don’t think in terms of, “Gee, I only slept 66% of the time in bed last night.” We think, “Darn, I only slept 5 hours.”
- Then why throw in the percentage of improvement when you provided the absolute minutes of reduced wakefulness? To do so is to increase the chances of confusion. Numbers can be numbing in overkill overdoses.
We were also troubled by a couple of comments:
“There are sleep aids on the market, but they do not work for everyone and they can have side effects that include sleepwalking, daytime drowsiness and confusion.” There is an implied suggestion that Suvorexant will not have these side effects but no data is provided
“Suvorexant works differently from those drugs, zeroing in on specific brain chemicals involved in the ability to sleep, explained study author Dr. William Herring, executive director of clinical research at Merck.” Yes, indeed Suvorexant does work differently than the currently available drugs but suggesting that “zeroing in” on sleep is a bit of an overstatement. The orexin 1 and 2 receptors have been shown in previous studies to effect energy, fluid homestasis, emotion regulation and stress responsiveness to name a few non-sleep effects (Vitamins & Hormones. 89:19-33, 2012)
Satisfactory
Strong ending that addressed this criterion:
Another sleep specialist said the findings show “some potential benefit” from suvorexant, but he cautioned insomnia sufferers against relying completely on any drug.
“Medication can be important,” said Dr. William Kohler, who directs the Florida Sleep Institute in Spring Hill. “But in the long run, the best methods for treating insomnia are behavioral techniques.”
Kohler said cognitive behavioral therapy — where people learn to change the thoughts and habits that affect their sleep quality — is a proven way to manage insomnia. For most people, he said, medication should be a temporary treatment; behavior change is the long-term fix.
Bazil agreed: “I look at most people with insomnia as someone who developed bad sleep habits.”
A drug, ideally used for a short time, may help encourage sleep and get people on the right track, Bazil said. “But those bad sleep habits — you’ve got to address them too,” he added.
“The problem,” Kohler noted, “is that we don’t want to make behavior changes. We want to pop a pill.”
Satisfactory
One of the independent experts addressed the drug’s relative novelty in this section:
“suvorexant is seen as a potentially important development in the world of sleep medicine, because the drug blocks specific brain chemicals called orexins, which help keep people awake. Standard sleep medications work more widely throughout the brain, Bazil explained, which is why they can have a host of side effects.
“The way [suvorexant] works makes a lot of sense,” Bazil said. “The hope is that it will help some people who haven’t responded to [other drugs], and have fewer side effects.”
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