Insomnia is a highly prevalent disorder that can occur in conjunction with other 
medical or psychiatric conditions or can occur in the absence of a coexisting 
disorder. Regardless, treatment of insomnia is beneficial to the patient and may 
benefit comorbidities if they exist. Nonpharmacologic modalities such as sleep 
hygiene and stimulus controls are important mainstays of insomnia therapy, but 
may not be sufficient to treat the disorder. Dual orexin receptor antagonists 
(DORAs) are a new class of insomnia medication that target wakefulness-promoting 
neuropeptides to regulate the sleep-wake cycle. Suvorexant is the first DORA to 
be approved and has demonstrated efficacy at decreasing both time to sleep onset 
and increasing total sleep time compared with placebo. Suvorexant has a novel 
mechanism of action and may represent an alternative for patients who cannot 
tolerate or do not receive benefit from traditional sleep agents. Suvorexant is 
generally effective and well tolerated, but has not been compared head to head 
with traditional sleep agents and being only newly available, lacks a 
longer-term 'real-world' experience base.