Cited by 448Sleep and related disordersObstructive Sleep Apnea ResearchPharmaceutical Practices and Patient Outcomes

The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.

The Efficacy and Safety of Drug Treatments for Chronic Insomnia in Adults: A Meta-analysis of RCTs

Open access

Buscemi, Nina, Vandermeer, Ben, Friesen, Carol, Bialy, Liza, Tubman, Michelle, Ospina, Maria, Klassen, Terry P., Witmans, Manisha·2007·Journal of General Internal Medicine

DOI 10.1007/s11606-007-0251-zPMC PMC2219774

Open this paper in CoChat — free account Open PDF

Abstract

Background Hypnotics have a role in the management of acute insomnia; however, the efficacy and safety of pharmacological interventions in the management of chronic insomnia is unclear.Objective The objective of this paper is to conduct a systematic review of the efficacy and safety of drug treatments for chronic insomnia in adults.Data sources Twenty-one electronic databases were searched, up to July 2006.Study selection Randomized double-blind, placebo-controlled trials were eligible. Quality was assessed using the Jadad scale. Data were pooled using the random effects model.Data synthesis One hundred and five studies were included in the review. Sleep onset latency, as measured by polysomnography, was significantly decreased for benzodiazepines (BDZ), (weighted mean difference: -10.0 minutes; 95% CI: -16.6, -3.4), non-benzodiazepines (non-BDZ) (-12.8 minutes; 95% CI: -16.9, -8.8) and antidepressants (ADP) (-7.0 minutes; 95% CI: -10.7, -3.3). Sleep onset latency assessed by sleep diaries was also improved (BDZ: -19.6 minutes; 95% CI: -23.9, -15.3; non-BDZ: -17.0 minutes; 95% CI: -20.0, -14.0; ADP: -12.2 minutes; 95% CI: -22.3, -2.2). Indirect comparisons between drug categories suggest BDZ and non-BDZ have a similar effect. All drug groups had a statistically significant higher risk of harm compared to placebo (BDZ: risk difference [RD]: 0.15; non-BDZ RD: 0.07; and ADP RD: 0.09), although the most commonly reported adverse events were minor. Indirect comparisons suggest that non-BDZ are safer than BDZ.Conclusions Benzodiazepines and non-benzodiazepines are effective treatments in the management of chronic insomnia, although they pose a risk of harm. There is also some evidence that antidepressants are effective and that they pose a risk of harm.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1007/s11606-007-0251-z

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582
Operating characteristics of a rank correlation test for publication bias
Begg, C. B., & Mazumdar, M. (1994) · Biometrics · doi:10.2307/2533446 · Cited by 16,955
Aspirin plus Clopidogrel as Secondary Prevention after Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis
Zhang, Q., Wang, C., Zheng, M., Li, Y., Li, J., Zhang, L., Shang, X., & Yan, C. (2014) · Cerebrovascular Diseases · doi:10.1159/000369778 · Cited by 11,609
Untitled work
Schulz (1995) · doi:10.1001/jama.1995.03520290060030 · Cited by 5,634
Efficacy and Safety of Tadalafil Monotherapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Meta-Analysis
Dong, Y., Hao, L., Shi, Z., Wang, G., Zhang, Z., & Han, C. (2013) · Urologia Internationalis · doi:10.1159/000351405 · Cited by 4,557
The Triad of Sleep Apnea, Hypertension, and Chronic Kidney Disease: A Spectrum of Common Pathology
Aziz, F., & Chaudhary, K. R. (2016) · Cardiorenal Medicine · doi:10.1159/000450796 · Cited by 3,285
A Nonparametric “Trim and Fill” Method of Accounting for Publication Bias in Meta-Analysis
Duval, S., & Tweedie, R. (2000) · Journal of the American Statistical Association · doi:10.1080/01621459.2000.10473905 · Cited by 2,955
Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.262.11.1479 · Cited by 2,440

Show all 39 references

Research works printed but not linked: 2

NIH 1983. Drugs and Insomnia: The Use of Medications To Promote Sleep. NIH Consens Statement Online 1983 Nov 5–17 [cited 2005 08 29];4(10):1–19.
Buscemi N, Vandermeer B, Friesen C, et al. Manifestations and management of chronic insomnia in adults. Evid Rep Technol Assess (Summ). 2005 Jun;(125):1–10.

Sorted by citations

Items 201–300 of 448

Pharmacology of Sleep Disorders in Children and Adolescents
Chhangani, B. S., Greydanus, D. E., Patel, D. R., & Feucht, C. L. (2011) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2010.11.003 · Cited by 16
Effect of acupuncture on insomnia following stroke: study protocol for a randomized controlled trial
Cao, Y., Yin, X., Soto-Aguilar, F., Liu, Y., Yin, P., Wu, J., Zhu, B.-C., Li, W., Lao, L., & Xu, S. (2016) · Trials · doi:10.1186/s13063-016-1670-0 · Cited by 15
“Although effective pharmacologic treatments for insomnia are available, these medications often cause side effects such as residual daytime sedation, drowsiness, dizziness, lightheadedness, cognitive impairment, motor incoordination, and dependence [8].”
Background
The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners
Lim, J.-H., Jeong, J.-H., Kim, S.-H., Kim, K.-O., Lee, S.-Y., Lee, S., & Kim, B.-K. (2018) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2018/9152705 · Cited by 15
“Though pharmacotherapy and behavioral treatments can be effective for insomnia, they have limitations, including poor adherence, abuse, dependence, side effects, and difficulties inherent in their implementation [10, 11].”
Background
A wearable EEG system for closed-loop neuromodulation of sleep-related oscillations
Bressler, S., Neely, R., Yost, R. M., Wang, D., & Read, H. L. (2023) · Journal of Neural Engineering · doi:10.1088/1741-2552/acfb3b · Cited by 14
“However, many such drugs are associated with a significant risk of harm relative to placebo and can be habit-forming (Buscemi et al 2007).”
Background
Alternative remedies for insomnia: a proposed method for personalized therapeutic trials
Romero, K., Goparaju, B., Russo, K., Westover, M. B., & Bianchi, M. T. (2017) · Nature and Science of Sleep · doi:10.2147/nss.s128095 · Cited by 14
“17 Interestingly, subjective diary measures of latency and TST exceeded the objective metrics of benefit by 50–300%.”
Pharmacological and non-pharmacological treatments for insomnia
Wang, C., Deng, C., Han, Q., Zhu, D.-L., Li, Z.-M., & Li, J. (2021) · Medicine · doi:10.1097/md.0000000000026678 · Cited by 9
“Some evidences concluded that the efficacy of sedating antidepressants is weaker than that for BZ/BZRAs.([13,16]) Melatonin is a hormone produced in the pineal gland under control of the circadian system in the hypothalamic suprachiasmatic nucleus (SCN).”
Sedative-Hypnotics Are Widely Abused by Drivers Apprehended for Driving Under the Influence of Drugs
Kriikku, P., Hurme, H., Wilhelm, L., Rintatalo, J., Hurme, J., Kramer, J., & Ojanperä, I. A. (2014) · Therapeutic Drug Monitoring · doi:10.1097/ftd.0000000000000138 · Cited by 15
“Zopiclone has been shown to be at least as effective as the benzodiazepines in the treatment of insomnia.(30) In an earlier study, the effects of zopiclone on driving performance were suggested to equal those of blood alcohol concentration of 1.”
Background
Chapter 87 – Pharmacologic Treatment of Insomnia: Benzodiazepine Receptor Agonists
Walsh, J., & Roth, T. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-24288-2.00087-8 · Cited by 7
Shifting characteristics of nonmedical prescription tranquilizer users in the United States, 2005–2014
Palamar, J. J., Han, B. H., & Martins, S. S. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.11.015 · Cited by 14
“While benzodiazepines may provide some short-term benefit for anxiety symptoms and sleep latency (Buscemi et al., 2007; Martin et al., 2007), they are not considered first-line treatment for either condition or recommended for long-term use (Morgenthaler et al.”
Background
Internet-Delivered Cognitive Behavioral Therapy for Insomnia
van der Zweerde, T., Lancee, J., Luik, A. I., & van Straten, A. (2019) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2019.04.002 · Cited by 14
Implementation of music in colorectal perioperative standard care—barriers and facilitators among patients and healthcare professionals
Kakar, E., van Ruler, O., van Straten, B., Hoogteijling, B., de Graaf, E. J. R., Ista, E., Lange, J. F., Jeekel, J. J., & Klimek, M. (2022) · Colorectal Disease · doi:10.1111/codi.16102 · Cited by 12
What to do about the Growing Number of Veterans with Diagnosed Sleep Disorders
Martin, J. L. (2016) · SLEEP · doi:10.5665/sleep.5956 · Cited by 13
Comparative efficacy and acceptability of pharmacological treatments for insomnia in adults: a systematic review and network meta-analysis
Crescenzo, F. D., Foti, F., Ciabattini, M., Giovane, C. D., Watanabe, N., Schepisi, M. S., Quested, D. J., Cipriani, A., Barbui, C., & Amato, L. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012364 · Cited by 13
Bitterness-Masking Effects of Different Beverages on Zopiclone and Eszopiclone Tablets
Yoshida, M., Kojima, H., Uda, A., Haraguchi, T., Ozeki, M., Kawasaki, I., Yamamoto, K., Yano, I., Hirai, M., & Uchida, T. (2019) · Chemical and Pharmaceutical Bulletin · doi:10.1248/cpb.c18-00502 · Cited by 13
Advances in the management of insomnia
Pigeon, W. R., Bishop, T. M., & Marcus, J. A. (2014) · F1000Prime Reports · doi:10.12703/p6-48 · Cited by 13
“And, notwithstanding some longer term trials of up to 12 months of nightly administration [18,52], concerns about long term use remain [20].”
Background
Effect of acupuncture and its influence on cerebral activity in perimenopausal insomniacs: study protocol for a randomized controlled trial
Wu, X., Zhang, W., Qin, Y., Liu, X., & Wang, Z. (2017) · Trials · doi:10.1186/s13063-017-2072-7 · Cited by 13
Digital Therapeutics for Insomnia: Assessing the Effectiveness of a Computerized Home-Based Cognitive Stimulation Program
Tapia, J. L., Puertas, F. J., & Duñabeitia, J. A. (2023) · Journal of Integrative Neuroscience · doi:10.31083/j.jin2202034 · Cited by 12
“The high negative effects associated with pharmacology (mainly related to the addictive power) [13,14] have led to the exploration of treatment alternatives in patients with sleep disturbances, and cognitive interventions have acquired a great deal of attention in recent years.”
Background
The effectiveness of smartphone app-based interventions for insomnia and sleep disturbances: A meta-analysis of randomized controlled trials
Linardon, J., Anderson, C., McClure, Z., Liu, C., & Messer, M. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.08.025 · Cited by 13
The art of sleep: examining sleep strategies in the general population with a focus on the use of music for sleep
Buus, R. M., Genovese, S., & Jespersen, K. V. (2025) · Journal of Sleep Research · doi:10.1111/jsr.70006 · Cited by 12
“Sleep medications, such as benzodiazepines, although being effective treatments in the management of insomnia, pose issues in the form of side effects, tolerance development, and dependence (Buscemi et al., 2007).”
Acupuncture for insomnia with short sleep duration: protocol for a randomised controlled trial
Wang, C., Yang, W., Yu, X., Fu, C., Li, J.-J., Wang, J., Xu, W., Zheng, Y., Chen, X., & Chen, Y.-F. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033731 · Cited by 12
Placebo for a single night improves sleep in patients with objective insomnia.
Rogev, E., & Pillar, G. (2013) · PubMed · Cited by 12
Self-help therapy for sleep problems in hospital nurses in Japan: a controlled pilot study
Morimoto, H., Tanaka, H., Ohkubo, R., Mimura, M., Ooe, N., 市川, あ., & Yukitoshi, H. (2015) · Sleep and Biological Rhythms · doi:10.1007/s41105-015-0037-3 · Cited by 12
“, benzodiazepines) are effective for alleviating sleep problems [6], prolonged use of sleeping medication has shortcomings, including deterioration of daytime functioning and & Hiroshi Morimoto morimoto@he.”
Background
Benzodiazepine Prescribing in People with Chronic Obstructive Pulmonary Disease: Clinical Considerations
Currow, D. C., & Agar, M. R. (2020) · Drugs & Aging · doi:10.1007/s40266-020-00756-z · Cited by 13
Hypnotics and Risk of Cancer: A Meta-Analysis of Observational Studies
Peng, T., Yang, L.-J., Wu, T., & Chao, Y. (2020) · Medicina · doi:10.3390/medicina56100513 · Cited by 12
Sleep Disturbances in Acutely Ill Patients with Cancer
Matthews, E. E., Tanner, J. M., & Dumont, N. A. (2016) · Critical Care Nursing Clinics of North America · doi:10.1016/j.cnc.2016.02.006 · Cited by 12
Sedative drug-use in Denmark, 2000 to 2019: a nationwide drug utilization study
Rosenqvist, T. W., Osler, M., Wium‐Andersen, M. K., & Wium‐Andersen, I. K. (2022) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-022-02409-5 · Cited by 12
“Previous metaanalyses have found that while benzodiazepines and Z-drugs reduced objective sleep latency with 10 and 13 min, respectively, and subjective sleep latency with 20 and 17 min respectively, melatonin reduced objective sleep latency with less than 6 min and subjective sleep latency with 11 min [36, 37].”
Implementation of music in the perioperative standard care of colorectal surgery ( IMPROVE study)
Kakar, E., van Ruler, O., Hoogteijling, B., de Graaf, E. J. R., Ista, E., Lange, J. F., Jeekel, J., & Klimek, M. (2024) · Colorectal Disease · doi:10.1111/codi.17200 · Cited by 11
Internet-delivered CBT intervention (Space for Sleep) for insomnia in a routine care setting: Results from an open pilot study
Wogan, R., Enrique, Á., Adegoke, A., Earley, C., Sollesse, S., Gale, S., Chellingsworth, M., & Richards, D. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100443 · Cited by 11
“…Received 14 April 2021; Received in revised form 5 August 2021; Accepted 8 August 2021 Internet Interventions 26 (2021) 100443 risk of physical dependence, withdrawal, rebound insomnia, and longterm health safety (Buscemi et al., 2007).”
Background
The Risk of Pneumonia in Older Adults Using Nonbenzodiazepine Hypnotics
Jung, S. P., Spence, M. M., Escasa, N. M., Lee, E. A., Hui, R. L., & Gibbs, N. E. (2016) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2016.22.8.932 · Cited by 11
“09).(11) Considering the potential adverse effects of any long-term pharmacologic treatment in older adults, more research is needed to identify and promote safer alternatives for insomnia.”
Background
GABA and Sleep: Molecular, Functional and Clinical Aspects
Reite, M. L. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.11010133 · Cited by 11
The effect of online cognitive behavioral therapy for insomnia in adolescents and young adults after childhood cancer: Results from a randomized controlled trial
van der Hoek, H., Peersmann, S. H. M., Maurice‐Stam, H., Kaspers, G. J. L., van den Bergh, E. M. M., Tissing, W. J. E., Kremer, L. C. M., Abbink, F. C. H., de Vries, A. C. H., Loonen, J. J., et al. (2025) · Cancer · doi:10.1002/cncr.35796 · Cited by 10
“26,27 Therefore,CBT - iisrecognizedasthefirst - linetreatment.”
“It could potentially be dangerous... but nothing else has seemed to help me.”: Patient and clinician perspectives on benzodiazepine use in opioid agonist treatment
Park, T. W., Sikov, J., dellaBitta, V., Saitz, R., Walley, A. Y., & Drainoni, M. (2021) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2021.108455 · Cited by 10
The acute effects of aerobic exercise on sleep in patients with depression: study protocol for a randomized controlled trial
Brupbacher, G., Straus, D., Porschke, H., Zander-Schellenberg, T., Gerber, M., von Känel, R., & Schmidt‐Trucksäss, A. (2019) · Trials · doi:10.1186/s13063-019-3415-3 · Cited by 11
Pharmacological interventions for benzodiazepine discontinuation in chronic benzodiazepine users
Baandrup, L., Ebdrup, B. H., Lindschou, J., Gluud, C. N., & Glenthoj, B. Y. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011481 · Cited by 10
The Role of Sleep in Psychological Well-Being in Athletes
Asplund, C. A., & Chang, C. J. (2020) · Springer eBooks · doi:10.1007/978-3-030-44754-0_23 · Cited by 11
Benzodiazepines in Patients with Heart Failure and Reduced Ejection Fraction.
Chuang, C., Hsiao, F., Cheng, Y., Lin, C., Tung, Y., Wu, C.-T., Chen, C.-Y., & Chu, P. (2022) · PubMed Central · doi:10.6515/acs.202209_38(5).20220406a · Cited by 9
Sleep and Its Modulation by Substances That Affect GABAA Receptor Function
Steiger, A. (2010) · Springer eBooks · doi:10.1007/978-3-0346-0226-6_5 · Cited by 9
Melatonin-rich milk fortified with alpha s1 casein tryptic hydrolysate improves primary insomnia: a randomized placebo controlled trial
Campbell, A. J., & Neill, A. M. (2016) · Sleep and Biological Rhythms · doi:10.1007/s41105-016-0063-9 · Cited by 9
“However, the improvements of NightMilk are inferior in the short-term to that shown by prescription hypnotics such as benzodiazepines, non-benzodiazepines and sedating antidepressants [26].”
Background
Management of Insomnia in Patients with Alcohol Use Disorder
Schubert, J. R., & Arnedt, J. T. (2017) · Current Sleep Medicine Reports · doi:10.1007/s40675-017-0066-3 · Cited by 10
“A multitude of pharmacologic interventions for insomnia are available and commonly used [21, 37].”
Background
Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit
Kripke, D. F. (2017) · F1000Research · doi:10.12688/f1000research.8729.2 · Cited by 12
Acupuncture for post-stroke insomnia
Xiang, J., Li, H., Xiong, J., Hua, F., Huang, S., Jiang, Y., Zhou, X., Liao, K., & Xu, L. (2020) · Medicine · doi:10.1097/md.0000000000021381 · Cited by 9
Self-efficacy enhancement can facilitate hypnotic tapering in patients with primary insomnia
Yang, C.-M., Tseng, C.-H., Lai, Y., & Hsu, S.-C. (2015) · Sleep and Biological Rhythms · doi:10.1111/sbr.12111 · Cited by 9
Anxiolytics and Sedative-Hypnotics
Gerlach, M., & Warnke, A. (2014) · Springer eBooks · doi:10.1007/978-3-7091-1501-5_6 · Cited by 9
Comparative short‐term safety and efficacy of hypnotics: A quantitative risk–benefit analysis
Cheung, J. M. Y., Scott, H., Muench, A., Grunstein, R. R., Krystal, A. D., Riemann, D. W., & Perlis, M. L. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14088 · Cited by 11
“…Parameter Guidelines on the Pharmacological Treatment of Insomnia (Sateia et al., 2017); (2) meta-analyses conducted by Buscemi and colleagues (Buscemi et al., 2007), Kuriyama and colleagues (Kuriyama et al., 2014), Yeung and colleagues (Yeung et al., 2015), Kuriyama and colleagues…”
Leitlinie „Insomnie bei Erwachsenen“ – Update 2025 (AWMF-Registernummer 063-003)
Spiegelhalder, K., Baum, E., Becker, M., Cornaro, C., Crönlein, T., Frase, L., Harth, V., Hertenstein, E., Johann, A. F., Mertel, I., et al. (2025) · Somnologie - Schlafforschung und Schlafmedizin · doi:10.1007/s11818-025-00530-6 · Cited by 12
Sleep, Sleep Deprivation, Sleeplessness and their Effect on Society
Sealy, E. A. (2022) · Scholars Journal of Applied Medical Sciences · doi:10.36347/sjams.2022.v10i10.011 · Cited by 8
Insomnia: Chasing the dream
Crow, J. M. (2013) · Nature · doi:10.1038/497s16a · Cited by 8
Current Pharmacological and Nonpharmacological Options for the Management of Insomnia
Pigeon, W. R., Bishop, T. M., & Marcus, J. A. (2013) · Clinical Medicine Insights Therapeutics · doi:10.4137/cmt.s10239 · Cited by 8
Electroacupuncture for insomnia disorder: study protocol for a randomized controlled trial
Kim, S.-P., Kim, J., Kim, B.-K., Kim, H.-J., Jung, I. C., Cho, J.-H., Kim, J.-E., Kim, A., Kwon, O., Kim, A.-R., et al. (2017) · Trials · doi:10.1186/s13063-017-1922-7 · Cited by 8
“However, while drug treatment can be effective for the short-term management of insomnia, there is little evidence whether efficacy is maintained in the long term, and adverse effects, including feelings of weakness during the daytime, mental slowing, dizziness, sensitivity to light, decreased exercise capacity, and d…”
Background
Comparison of Melatonin and Zolpidem for Sleep in an Academic Community Hospital: An Analysis of Patient Perception and Inpatient Outcomes
Stoianovici, R. N., Brunetti, L., & Adams, C. (2019) · Journal of Pharmacy Practice · doi:10.1177/0897190019851888 · Cited by 8
SOOJI CHIM (Koryo hand acupuncture) for perimenopausal insomnia: Evidence from actigraphy and serum hormone testing
Zhao, F.-Y., Kim, J.-H., Yue, L.-P., Yan, H., Song, H., Xu, Y., Xu, H., Hong, Y.-F., & Fu, Q.-Q. (2019) · 世界针灸杂志：英文版 · doi:10.1016/j.wjam.2019.11.007 · Cited by 8
The effect of baclofen on objective and subjective sleep measures in a model of transient insomnia
Raad, S., Wilkerson, M., Jones, K. R., & Orr, W. C. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.03.028 · Cited by 8
Implementation of music in the perioperative standard care of colorectal surgery: study protocol of the IMPROVE Study
Kakar, E., Ista, E., Klimek, M., & Jeekel, J. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-051878 · Cited by 8
The Subjective and Objective Improvement of Non-Invasive Treatment of Schumann Resonance in Insomnia—A Randomized and Double-Blinded Study
Huang, Y., Tang, I., Chin, W., Jang, L., Lee, C., Lin, C., Yang, C., & Cho, S.-L. (2022) · Nature and Science of Sleep · doi:10.2147/nss.s346941 · Cited by 8
“The long-term use and overdoses of sleeping pills may cause side effects.(13,14) Although the insomnia treatment guidelines provide established clinical practice recommendations for CBTi as a first-line treatment, such treatment has not been popularized in many countries so far.”
Background
Comparative efficacy of hypnotics in young and middle-aged adults with insomnia: a systematic review and network meta-analysis
Hasan, F., Lee, H., Chen, P., Wang, Y., Yuliana, L. T., Romadlon, D. S., Tu, Y., & Chiu, H. (2023) · Sleep And Breathing · doi:10.1007/s11325-023-02812-5 · Cited by 9
Insomnia: definition, prevalence, health risks and therapy approaches
Пизова, Н. В. (2023) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2023-034 · Cited by 8
Utilization of psychotropic drugs by patients consulting for sleeping disorders in homeopathic and conventional primary care settings: the EPI3 cohort study
Grimaldi‐Bensouda, L., Abenhaim, L., Massol, J., Guillemot, D., Avouac, B. P., Duru, G., Lert, F., Magnier, A., Rossignol, M., Rouillon, F., et al. (2015) · Homeopathy · doi:10.1016/j.homp.2015.05.002 · Cited by 8
Efficacy of abdomen-rubbing qigong exercise for chronic insomnia: study protocol for a randomized controlled trial
Guan, C., Cheng, Z., Xie, F., Wang, R., Zhang, J., Yao, F., & Fang, M. (2021) · Trials · doi:10.1186/s13063-021-05528-7 · Cited by 8
“Researches show that the incidence rate in Japan is 37.2%, in the USA is 27.1%, and in China is 15.0% [3, 4].”
BackgroundInfluential
Insomni
Bjorvatn, B., Sivertsen, B., Øyane, N., Nordhus, I. H., & Pallesen, S. (2009) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.08.0379 · Cited by 8
Who Should Sponsor Sleep Disorders Pharmaceutical Trials?
Kripke, D. F. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27020 · Cited by 8
Prognostic models for predicting insomnia treatment outcomes: A systematic review
Holler, E., Du, Y., Barboi, C., & Owora, A. H. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.12.017 · Cited by 8
Isorauhimbine and Vinburnine as Novel 5-HT2A Receptor Antagonists From Rauwolfia serpentina for the Treatment of Insomnia: An In Silico Investigation
Abbas, K., Alam, M., Ansarì, M. S., Khan, A., Raza, M. T., Khan, Z., Ibraheem, M., Mustafa, M., & Usmani, N. (2024) · Chronobiology in Medicine · doi:10.33069/cim.2024.0023 · Cited by 7
“…the usefulness of these medications has been well established, their usage is limited by side effects such as daytime sedation (such as hangover in the morning or the next day), cognitive impairment (including anterograde amnesia), motor incoordination, misuse potential, and dependence [35].”
I petitioned the FDA to restrict hypnotics: here is why
Kripke, D. F. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2015.12.011 · Cited by 7
“The most authoritative NIH-sponsored meta-analysis concluded that "Z" hypnotics do not significantly increase polysomnographic total sleep time, even though much higher doses were included in that meta-analysis [10].”
Background
COMISA (Comorbid Insomnia and Sleep Apnea): a Practical Approach
Brock, M. S., Foster, S. N., Motamedi, V., & Mysliwiec, V. (2018) · Current Sleep Medicine Reports · doi:10.1007/s40675-018-0127-2 · Cited by 10
The Concomitant Pattern of Association Between Subjective Global Sleep Quality and Daytime Dysfunction in Hypnotic-Treated Older Adults: The Yilan Study, Taiwan
Lin, C.-H., Hsu, N., Chen, H., & Chou, P. (2022) · Nature and Science of Sleep · doi:10.2147/nss.s353141 · Cited by 8
“In previous studies, outcome measurements of hypnotic efficacy focused predominantly on changes in nighttime symptoms of insomnia(4) rather than improvements in subjective sleep quality and next-day function.(13) Thus, “improving sleep quality” and “restoring daytime function” have recently been suggested as two essen…”
Background
Study Protocol for a Randomized Controlled Trial Assessing the Effectiveness of Personalized Computerized Cognitive Training for Individuals With Insomnia
Tapia, J. L., Puertas, F. J., & Duñabeitia, J. A. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2022.779990 · Cited by 7
Ovarian Suppression: Early Menopause, Late Effects
Goldberg, C., Greenberg, M. R., Noveihed, A., Agrawal, L. S., Omene, C. O., Toppmeyer, D., & George, M. A. (2024) · Current Oncology Reports · doi:10.1007/s11912-023-01491-5 · Cited by 8
“Pharmacologic interventions are commonly used but they have substantial side effects of residual daytime sedation, cognitive impairment, dependence, worsening underlying sleep apnea or hypoventilation, memory disturbances, driving accidents, and falls [46–48].”
Efficacy and Safety of Naproxen for Acute Pain
Weisman, S. R. (2020) · The Journal of Family Practice · doi:10.12788/jfp.0064 · Cited by 8
Using radionuclide esophageal emptying test to evaluate pneumatic dilatation effects for achalasia.
Shen, Y., Shiau, Y. ‐., Sun, S. S., & Kao, C. H. (2001) · PubMed · Cited by 7
Zopiclone for insomnia
Rösner, S., Soyka, M., Hajak, G., Wehrle, R., & Englbrecht, C. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010701 · Cited by 6
Managing the Burden of Dementia-Related Delusions and Hallucinations
Small (2020) · The Journal of Family Practice · doi:10.12788/jfp.0065 · Cited by 6
Home exercise improves the quality of sleep and daytime sleepiness of elderlies: a randomized controlled trial
Brandão, G. S., Gomes, G. S. B. F., Brandão, G. S., Sampaio, A. A. C., Donner, C. F., de Oliveira, L. V. F., & Camelier, A. A. (2018) · Multidisciplinary Respiratory Medicine · doi:10.4081/mrm.2018.74 · Cited by 6
Association Between Benzodiazepines and Dementia in South Korea: A Nation-Wide Study
Sun, T. H., Yeom, J. W., Cho, C., & Lee, H. (2022) · Chronobiology in Medicine · doi:10.33069/cim.2022.0028 · Cited by 6
“Additionally, benzodiazepines are frequently used to reduce rapid eye movement (REM) sleep and sleep onset latency [5,6], which aids in restoration of psychological function.”
Benzodiazepine & nonbenzodiazepine prescriptions for Taiwanese elderly with type 2 diabetes contributes to cognitive dysfunction
Lai, Y., Yang, Y., Tsai, M.-L., Huang, C., & Chiou, J. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214000908 · Cited by 6
Ramelteon combined with an α1-blocker decreases nocturia in men with benign prostatic hyperplasia
Kawahara, T., Morita, S., Ito, H., Terao, H., Sakata, R., Ishiguro, H., Tanaka, K., Miyamoto, H., Matsuzaki, J., Kubota, Y., et al. (2013) · BMC Urology · doi:10.1186/1471-2490-13-30 · Cited by 6
“Moreover, it has a similar efficacy but is associated less frequently with next-day sedation and carries a lower risk of dependence [34,35].”
Background
Pharmacopuncture Effects on Insomnia Disorder: Protocol for a Multi-Site, Randomized, Acupuncture-Controlled, Clinical Trial
Lim, J.-H., Lee, J.-H., Kwon, C., Lee, S., Kang, C., Cho, E., Kim, H.-W., Cho, J.-H., & Kim, B.-K. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416688 · Cited by 7
Complementary and Alternative Medicine in Clinical Practice Guideline for Insomnia
Kwon, C.-Y., Suh, H.-W., Choi, E.-J., Chung, S.-Y., & Kim, J. (2016) · Journal of Oriental Neuropsychiatry · doi:10.7231/jon.2016.27.4.235 · Cited by 7
A Review on Clinical Research Trend in Treatment of Chai-Hu-Shu-Gan-San (Sihosogan-San) for Insomnia
Lee, J., Kim, S.-H., Kim, B.-K., & Lim, J.-H. (2020) · doi:10.7231/jon.2020.31.1.025 · Cited by 6
Circadian Rhythm Sleep-Wake Disorders
Bothwell, M. Y., & Abbott, S. M. (2022) · Respiratory medicine · doi:10.1007/978-3-030-93739-3_14 · Cited by 7
Effects of different doses of triazolam in the middle-of-the-night insomnia: a double-blind, randomized, parallel group study
Ferini‐Strambi, L., Marelli, S., Zucconi, M., Galbiati, A., & Biggio, G. (2017) · Journal of Neurology · doi:10.1007/s00415-017-8530-z · Cited by 6
“They reduce the time to the onset of sleep, prolong stage 2 sleep, prolong total sleep time, and may slightly reduce the relative amount of rapid eye movement (REM) sleep [10].”
Background
Adverse events of pharmacological interventions for insomnia disorder in adults: a systematic review and network meta-analysis
Lu, C., Geng, Y., Guan, X., Meng, Y., Zhu, M., & Zhao, Y. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1461166 · Cited by 5
Characteristics of psychiatric patients with nightmares after suvorexant administration: A retrospective study
Yasuda, K., Hirano, Y., Takeda, R., Ikeda, R., & Ishida, Y. (2024) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12506 · Cited by 5
Survey of Insomnia Treatment Status for Doctors
Choi, Y., Lee, M. H., Choi, J.-W., Kim, S., Kim, J., & Lee, Y. J. (2016) · Sleep Medicine and Psychophysiology · doi:10.14401/kasmed.2016.23.2.77 · Cited by 5
Detection of diazepam in spiked drink using thin-layer chromatography
Kamble, A., Kennady, C. J., Badiye, A., & Kapoor, N. (2022) · Journal of Planar Chromatography – Modern TLC · doi:10.1007/s00764-022-00208-x · Cited by 5
Daridorexant for patients with chronic insomnia disorder: number needed to treat, number needed to harm, and likelihood to be helped or harmed
Chalet, F.-X., Luyet, P., Rabasa, C., Vaillant, C., Saskin, P., Ahuja, A., & Citrome, L. (2024) · Postgraduate medicine · doi:10.1080/00325481.2024.2359891 · Cited by 5
“Pharmacotherapies are recommended as second-line treat-ment, but generally for short-term use due to safety concerns [19,20].”
Background
Efficacy and safety of lemborexant vs placebo in treating adults with insomnia disorder: a systematic review and meta-analysis of 1976 patients
Alsaied, M. A., Elettreby, A. M., Serag, I., Rajput, J., Zabady, N. A., Li, H., & Elnaga, A. A. A. (2025) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-025-04072-4 · Cited by 7
“Over the past decades, the use of antihistamines and tricyclic antidepressants has increased, but they are associated with substantial side effects such as rebound insomnia after withdrawal, liver dysfunction, and heart rhythm disturbances (Buscemi et al. 2007).”
Antidepressants for insomnia
Everitt, H., Baldwin, D. S., Mayers, A., Malizia, A. L., & Wilson, S. J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010753 · Cited by 5
The Efficacy and Safety of Long-Term Use of Hypnotics
Yang, K. I., & Hwangbo, Y. (2010) · Journal of Korean Sleep Research Society · doi:10.13078/jksrs.10005 · Cited by 5
“한 예 로 56개의 RCT 중에서 제약회사 후원으로 이루어지지 않 은 것은 단 5개에 불과하였다.(17) 이들 제약회사 후원으로 이”
Zaleplon for insomnia
Rösner, S., Soyka, M., Hajak, G., Wehrle, R., & Englbrecht, C. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010702 · Cited by 5
Zolpidem for insomnia
Rösner, S., Soyka, M., Hajak, G., Wehrle, R., & Englbrecht, C. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010700 · Cited by 5
Chronic Insomnia, Pharmacotherapy and the Cognitive Behavioral Approaches
Nami, M. (2014) · Journal of Sleep Disorders & Therapy · doi:10.4172/2167-0277.1000151 · Cited by 5
Benzodiazepine prescriptions on merchant ships without a doctor on board: analysis from medical records of Centro Internazionale Radio Medico (CIRM)
Nittari, G., Pallotta, G., Canio, M. D., Traini, E., & Amenta, F. (2018) · International Maritime Health · doi:10.5603/imh.2018.0005 · Cited by 6
“The effectiveness of the benzodiazepines exceeds the placebo in controlling a wide range of anxiety related symptoms [2, 3] and reducing the onset of insomnia [4].”
Background
Insomnia: risk factors, sex- and age-specific features, and therapeutic approaches
Пизова, Н. В., Pizov, A. V., & Solovyov, I. N. (2022) · Meditsinskiy sovet = Medical Council · doi:10.21518/2079-701x-2022-16-11-62-70 · Cited by 5
Psychopharmacology of sleep disorders
Singh, B., McArdle, N., & Hillman, D. R. (2019) · Handbook of clinical neurology · doi:10.1016/b978-0-444-64012-3.00021-6 · Cited by 5
Clinical Medicine Insights: Geriatrics
Sakuraba, A. (2018) · Clinical Medicine Insights Geriatrics · doi:10.4137/cmger · Cited by 5
Efficacy of Remote Cognitive Behavioural Therapy for Insomnia in Improving Health Status of Patients with Insomnia Symptoms: A Meta-analysis
Xu, D., Li, Z., Leitner, U., & Sun, J. (2024) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10458-6 · Cited by 5
“Further, the long-term effects are limited (Buscemi et al., 2007).”
The impact of hypnotic use on health problems in the community-dwelling elderly
Hoshino, C. (2015) · An Official Journal of the Japan Primary Care Association · doi:10.14442/generalist.38.228 · Cited by 4
Residual effects of eszopiclone and placebo in healthy elderly subjects: a randomized double-blind study
TAKAHASHI, J. C., Kanbayashi, T., Uemura, S. I., Sagawa, Y., Tsutsui, K., Takahashi, Y., Omori, Y., Imanishi, A., Takeshima, M., Satake, M., et al. (2017) · Sleep and Biological Rhythms · doi:10.1007/s41105-017-0101-2 · Cited by 4
“Non-BZ agents are much more selective for the BZ receptor subtypes (GABAA) and have reportedly fewer side effects [19, 20].”
Pharmacologic Management of Allergic Disease and Sleep
Panek, N., Le, K. T., Moran, T., & Mudahar, S. (2019) · Springer eBooks · doi:10.1007/978-3-030-14738-9_28 · Cited by 4
Deprescribing of chronic benzodiazepine receptor agonists for insomnia in adults
Ma, A., Thompson, W., Polemiti, E., Hussain, S., Magwood, O., Welch, V. A., Farrell, B. J., & Pottie, K. C. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013371 · Cited by 4

Authors: Buscemi, N., Vandermeer, B., Friesen, C., Bialy, L., Tubman, M., Ospina, M., Klassen, T. P., & Witmans, M.
Affiliations: University of Alberta (CA)
Corresponding author: Bialy, Liza
ORCID: Vandermeer, Ben
Bialy, Liza
Ospina, Maria
Klassen, Terry P.
Witmans, Manisha
Venue: Journal of General Internal Medicine
Publisher: Springer Science and Business Media LLC
Published: 2007-07-10
Volume: 22
Issue: 9
Pages: 1335-1350
ISSN: 0884-8734 (ISSN-L)
1525-1497
DOI: 10.1007/s11606-007-0251-z
PMC: PMC2219774
OpenAlex: W2002669039
Cited by: 448
References: 39
Citations by year: 2026: 8 · 2025: 17 · 2024: 18 · 2023: 19 · 2022: 32 · 2021: 23 · 2020: 39 · 2019: 28 · 2018: 29 · 2017: 30 · 2016: 34 · 2015: 27 · 2014: 28 · 2013: 23 · 2012: 25
FWCI: 2.64
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of General Internal Medicine (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Health and Human Services
National Institutes of Health
Agency for Healthcare Research and Quality
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords: chronic insomnia, hypnotics, benzodiazepines, non-benzodiazepine hypnotics, antidepressants, sleep latency, drug efficacy, drug safety, adverse events, adults
MeSH terms: Adult, Aged, Antidepressive Agents, Benzodiazepines, Female, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Randomized Controlled Trials as Topic, Polysomnography

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

The Efficacy and Safety of Drug Treatments for Chronic Insomnia in Adults: A Meta-analysis of RCTs

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks