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 accessAbstract
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.
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“BZDs are effective in the treatment of anxiety disorders [2,3,4] and insomnia [5,6].”
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Metadata
- 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
- Venue
- Journal of General Internal Medicine
- Published
- 2007-07-10
- Volume
- 22
- Issue
- 9
- Pages
- 1335-1350
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- 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
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