2026 Volume 77 Issue 1 Pages 22-28
A 52-year-old woman presented with complaints of insomnia and daytime fatigue. She had a history of worsening nighttime awakenings, nocturia, and excessive daytime sleepiness over the past year. Following a sleep study, the patient was diagnosed with severe obstructive sleep apnea (OSA), with a respiratory disturbance index (RDI) of 41.3. Continuous positive airway pressure (CPAP) therapy was initiated, resulting in improvement in nocturia and edema, but she continued to experience difficulty falling asleep. Lemborexant was prescribed as needed, which improved sleep onset but caused increased daytime fatigue. After discontinuing lemborexant, the patient was treated with Sansoninto (Suan Zao Ren Tang), a traditional herbal medicine. The use of Sansoninto improved insomnia symptoms without causing daytime drowsiness or fatigue. CPAP adherence was maintained, and the patient reported no worsening of CPAP-related parameters such as median pressure or leak rates. Sansoninto appeared to be an effective and safe alternative for managing insomnia during CPAP therapy, without affecting CPAP adherence or the effectiveness of CRAP therapy.
