Efficacy and Safety of Lemborexant for Patients With Cirrhosis and Sleep Problems

Inclusion Criteria: * adults aged 18 years or older; * willingness to participate in the clinical trial as evidenced by written informed consent; documented diagnosis of liver cirrhosis in the medical record, with disease severity assessed using the Child-Pugh score and supported by imaging findings consistent with cirrhosis on FibroScan or ultrasonography; * presence of sleep disturbance defined by a Pittsburgh Sleep Quality Index (PSQI) score greater than 5; * patients receiving inpatient or outpatient care at Cipto Mangunkusumo National General Hospital; * ability to take oral medication; * willingness of the patient or caregiver to maintain a sleep diary throughout the study period; * ability of the patient or caregiver to comply with the clinical trial protocol and complete scheduled serial assessments. Exclusion Criteria: * advanced liver cirrhosis defined as Child-Pugh class C; * current use of medications with significant interactions affecting the metabolism of Lemborexant, including itraconazole, clarithromycin, fluconazole, verapamil, tramadol, rifampicin, carbamazepine, bosentan, efavirenz, etravirine, and modafinil; * ongoing alcohol consumption or intake of grapefruit juice during the study period; * pregnancy, breastfeeding, or plans to become pregnant during the study; * presence of significant comorbid conditions such as autoimmune disease, * stage V chronic kidney disease, HIV/AIDS, or known or suspected hypersensitivity to the investigational drug; * concurrent participation in another clinical trial at the time of screening.