• actigraphy
• chronic insomnia
• Daridorexant
• dual orexin receptor antagonist (DORA)
• efficacy
• objective sleep assessment
• personalized therapy
• predictors
• real-world study
• sleep disorders
• sleep misperception
• subjective sleep assessment
• therapeutic regimen
• total sleep time (TST)
• treatment response

Background: Chronic insomnia disorder is a highly prevalent condition with signifi-cant comorbidities. Daridorexant, a dual orexin receptor antagonist (DORA), offers a novel mechanism that targets wakefulness. Objective: This real-world study evaluated Daridorexant's clinical effectiveness using subjective and objective sleep assessments, investigated its effect on sleep misperception, and identified predictors of treatment re-sponse. Methods: Twenty-eight chronic insomnia patients were treated for three months. Subjective and objective sleep parameters were assessed using question-naires/diaries and actigraphy. Sleep misperception was quantified as the discrepancy between these measures. Results: Daridorexant significantly improved subjective TST (4.5 to 6.25 hours, p<0.001) and actigraphic TST (6.82 to 7.42 hours, p=0.006). TST misperception was reduced from -1.96 hours to -0.57 hours (p=0.012), showing en-hanced alignment between perceived and actual sleep. Treatment response was modu-lated by age, sex, BMI, and therapeutic regimen. Conclusion: The study provides compelling evidence of Daridorexant's efficacy and favorable tolerability. Our findings show the drug effectively reduces sleep misperception and suggest that personalized therapeutic strategies should consider baseline patient characteristics. Further research is warranted.