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Orexin (hypocretin) is a neurotransmitter involved in reward, eating, activity, arousal, and the sleep–wake cycle. Orexin levels in cerebrospinal fluid decrease during sleep. To examine whether almorexant — an antagonist of orexin-A and orexin-B (hypocretin 1 and 2) receptors — might improve sleep without daytime impairment, as occurs with many benzodiazepine receptor agonists, researchers conducted an international, manufacturer-sponsored, crossover trial. The 153 participants (mean age, 45) with chronic primary insomnia (including decreased total sleep, difficulty falling asleep, and daytime problems related to lack of sleep) received a single dose of almorexant or placebo, in random order, 1 week apart, and underwent all-night polysomnog…