Belsomra (suvorexant) is a prescription medication designed to help manage insomnia. It specifically targets and modulates the orexin system, a neurotransmitter system involved in regulating wakefulness. This article provides clarity on potentially severe side effects, often described as “horror stories,” reported by users.
The Unsettling Side Effects
Some individuals taking Belsomra have reported experiencing sleep paralysis, a phenomenon where they become conscious but are temporarily unable to move or speak. This can occur either when falling asleep or upon waking, lasting for several seconds to several minutes.
Users have also reported vivid hallucinations and intense nightmares. These hallucinations can be hypnagogic, occurring as one drifts off to sleep, or hypnopompic, happening upon awakening. They may involve seeing or hearing things that are not present. The nightmares are frequently reported as unusually intense, vivid, and emotionally distressing, sometimes leading to heightened anxiety about sleep.
A particularly concerning category of reported effects includes complex sleep behaviors, where individuals engage in activities while not fully awake and have no memory of the events afterward. These behaviors can range from sleepwalking and sleep-eating to more dangerous actions like attempting to drive a vehicle or making phone calls. Such episodes pose significant safety risks to the individual and others, underscoring the serious nature of these potential reactions.
Why These Reactions May Occur
The unique mechanism of Belsomra offers insight into why these unsettling reactions can manifest. Belsomra functions as an orexin receptor antagonist, meaning it blocks the activity of orexin, a neuropeptide. Orexin A and orexin B are neurotransmitters that play a primary role in promoting wakefulness and maintaining alertness throughout the day.
By suppressing this wake-promoting signal, Belsomra aims to facilitate the transition into sleep. However, this suppression can sometimes lead to a blurred boundary between sleep and wakefulness states in the brain. This “mixed state” can result in parts of the brain being partially awake while other parts remain in a sleep-like state. This physiological phenomenon can explain instances of sleep paralysis, where the mind is alert but the body’s muscle tone is still inhibited as if in REM sleep. Similarly, the intrusion of dream states into periods of partial wakefulness can lead to vivid hallucinations or intense nightmares.
Context and Medical Guidance
It is important to understand that while these “horror stories” are alarming, they represent more severe potential side effects and do not occur in every individual taking Belsomra. The reported incidence of these severe events in clinical trials has been relatively low, although individual responses to medication vary.
If you or someone you know experiences any of these unsettling reactions or any other concerning side effects while taking Belsomra, it is imperative to contact the prescribing doctor immediately. A medical professional is the only one who can provide appropriate guidance, which may involve adjusting the dosage or discontinuing the medication altogether. Self-adjusting medication or ignoring severe side effects can lead to further complications.