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Sleep is not a luxury—it is a biological necessity. It supports everything from emotional regulation and immune defense to cardiovascular health and cognitive performance. Yet for millions of people around the world, restful sleep remains out of reach. Chronic insomnia, defined as difficulty falling or staying asleep for at least three nights a week for more than three months, affects up to 30% of adults globally. It doesn’t just lead to fatigue. It increases the risk of anxiety, depression, heart disease, metabolic disorders, and neurodegeneration, while impairing work, relationships, and overall quality of life.
For decades, the mainstays of insomnia treatment have been cognitive behavioral therapy for insomnia (CBT-I) and sedative medications. CBT-I remains the gold standard, but access is limited, and not all patients respond. Sedatives like benzodiazepines and Z-drugs can offer short-term relief but are often associated with dependence, next-day grogginess, and cognitive side effects—especially in older adults.
Fortunately, the treatment landscape is shifting. A recent Nature Outlook article highlights a wave of innovation in insomnia care. From cutting-edge pharmaceuticals and cannabis-derived compounds to wearable neurotechnology and digital behavioral tools, these emerging therapies are pushing the field toward smarter, safer, and more individualized care.
A New Kind of Sleep Drug: Blocking Wakefulness, Not Forcing Sedation
A breakthrough has emerged in the form of dual orexin receptor antagonists (DORAs), a new class of medications that target the brain’s orexin system—a key driver of wakefulness. Rather than sedating the entire brain, DORAs work by preventing orexin from activating its receptors, thereby allowing sleep to emerge naturally.
Drugs like suvorexant, lemborexant, and daridorexant have shown the ability to help patients fall asleep and stay asleep, with fewer next-day side effects than traditional sedatives. Daridorexant, in particular, also demonstrated improvements in daytime functioning in clinical trials, suggesting more restorative and better-aligned sleep.
A newer compound, seltorexant, is being studied in patients with both insomnia and major depressive disorder. Early findings suggest that this drug not only improves sleep but also mood, opening the door to a more integrated approach to managing comorbid psychiatric symptoms.
From Cannabis to Cannabinol: Rethinking Plant-Based Sleep Aids
Cannabis is widely used to self-treat insomnia, but the science has often lagged behind the anecdotal enthusiasm. Of the many cannabinoids present in the plant, cannabinol (CBN) is now showing the most promise. Unlike THC and CBD, which have produced inconsistent or negative sleep outcomes in clinical studies, CBN appears to improve sleep latency—how quickly one falls asleep—without impairing REM sleep or causing significant cognitive side effects.
In one trial, individuals taking 300 mg of CBN fell asleep seven minutes faster than placebo, which is comparable to the effects of many prescription sleep drugs. Researchers are now planning larger, longer-term studies to confirm whether CBN could become a viable, evidence-based treatment option.
Despite the popularity of CBD and THC, the evidence so far doesn’t support their use as reliable sleep aids. In some trials, they even reduced total sleep time. The future of cannabis-derived sleep therapy likely lies in these lesser-known molecules that target sleep more precisely.
Brain-Based Sleep Support: The Rise of Wearable Neurotechnology
Sleep medicine is also entering the age of neurotechnology. New wearable devices are being designed not just to track sleep, but to actively improve it. These devices monitor brain activity in real time and deliver gentle auditory tones or electrical pulses to enhance slow-wave sleep, the most restorative stage of the sleep cycle.
In early trials, individuals with insomnia who typically struggled for more than 30 minutes to fall asleep managed to reduce sleep onset by over 10 minutes using auditory stimulation devices. Increasing time spent in deep sleep may also benefit cognitive function, memory, and immune health—all of which are disrupted in chronic insomnia.
Although these tools are still in development, they represent a promising non-drug alternative, especially for individuals who are medication-averse or have failed standard therapies.
Digital CBT-I: Evidence-Based Therapy, Now on Your Phone
While CBT-I remains the first-line treatment for insomnia, access to trained therapists is often a bottleneck. That’s where digital CBT-I platforms come in. Programs like SleepioRx, which recently received FDA clearance, deliver structured CBT-I protocols via mobile apps and web platforms, guiding users through behavior change strategies such as stimulus control, sleep restriction, and cognitive reframing.
Digital CBT-I has shown clinical efficacy on par with in-person therapy in multiple randomized controlled trials. These tools can dramatically expand access to care, especially in rural or under-resourced areas, and offer scalable options for integrating sleep therapy into primary care or workplace wellness programs.
The Future: Personalized, Multi-Modal Sleep Care
What ties these innovations together is a movement away from “one-size-fits-all” sedation toward more precision-based, multi-modal sleep medicine. Whether through selective receptor blockade, cannabinoid modulation, brainwave synchronization, or digital behavior change, the goal is no longer just to knock people out—but to restore healthy, natural sleep cycles that support daytime well-being.
In the future, treatment may be tailored not just to a diagnosis, but to an individual’s genetics, comorbidities, sleep architecture, and lifestyle. This personalized approach will allow clinicians to combine modalities—pharmacological, behavioral, and technological—for maximum effect with minimal side effects.
For the millions suffering silently with insomnia, these innovations offer more than just a better night’s rest. They offer a renewed chance at vitality, resilience, and full participation in life. And for health professionals and systems, they signal a new chapter in sleep medicine—one rooted in science, guided by data, and focused on outcomes that matter. As always, please consult a healthcare professional before making any decisions regarding the new treatment options discussed here.
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About the author
Alen Juginović is a medical doctor and postdoctoral researcher in the Department of Neurobiology at Harvard Medical School studying the effect of poor sleep quality on health. He is the author of Sleep Science Made Simple, a book that explains how sleep affects the brain and body using clear, accessible language for both professionals and the general public. He is a member of the Editorial Board of the Journal of Clinical Sleep Medicine, the official journal of the American Academy of Sleep Medicine. As a keynote speaker at conferences and teacher at Harvard College, he often discusses sleep's importance during the educational process and in media appearances. Alen is also focused on personalized sleep optimization for individuals and athletes (e.g. jet lag management), as well as being an advisor/investor/consultant for companies and individuals in the sleep field. He leads a team at Med&X Association organizing international award-winning conferences, including the Plexus Conference, which drew over 2,400 participants from 30+ countries, featuring 10 Nobel laureates and medical leaders. Med&X also collaborates with research labs and clinics from leading universities and hospitals around the world offering invaluable internships to help accelerate the development of top medical students, physicians and scientists. Feel free to contact Alen via LinkedIn for any inquiries.
Disclaimer: The content provided in this newsletter is for informational and educational purposes only. It is not intended as medical or professional advice. The reader should consult with a medical professional for medical conditions or concerns, and with a financial or legal professional regarding any other specific needs or inquiries they may have related to the material discussed.
The writer expressly disclaims responsibility, obligation, or liability for actions taken by the reader in their unique circumstances based on any guidance, suggestions or recommendations made in this newsletter related to sleep health, optimization or hygiene. This content is not a substitute for personalized medical diagnosis, treatment or care from a trained physician.
The writer has made good faith efforts to confirm that all sleep science, research or health statistics referenced from third party sources are accurately represented. However, no warranty is made as to completeness or ongoing accuracy. Readers agree any reliance on newsletter content for decision making is at their sole discretion and risk. The writer is released of liability or claims related to applied use of this general educational content on sleep physiology or best practices.
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