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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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Citations
Cites
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
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
Schulz (1995) · doi:10.1001/jama.1995.03520290060030 · Cited by 5,634
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
Systematic Reviews in Health Care : Meta-Analysis in Context
Egger, M., Smith, G. D., & Altman, D. G. (2000) · Cited by 2,312
Epidemiologic Study of Sleep Disturbances and Psychiatric Disorders: An Opportunity for Prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.1989.03430110069030 · Cited by 2,252
Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2001) · Systematic Reviews in Health Care · doi:10.1002/9780470693926.ch15 · Cited by 2,163
Bucher, H. C., Guyatt, G. H., Griffith, L. E., & Walter, S. D. (1997) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(97)00049-8 · Cited by 2,052
Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young Adults
Breslau, N., Roth, T., Rosenthal, L., & Andreski, P. (1996) · Biological Psychiatry · doi:10.1016/0006-3223(95)00188-3 · Cited by 1,831
Summing up: The Science of Reviewing Research
Wilkinson, I., Light, R. J., & Pillemer, D. B. (1987) · Journal of Educational Statistics · doi:10.2307/1164691 · Cited by 1,486
Light, R. J., & Pillemer, D. B. (1984) · Harvard University Press eBooks · doi:10.4159/9780674040243 · Cited by 1,422
Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits
Glass, J., Lanctôt, K. L., Herrmann, N., Sproule, B. A., & Busto, U. E. (2005) · BMJ · doi:10.1136/bmj.38623.768588.47 · Cited by 1,161
Comparative Meta-Analysis of Pharmacotherapy and Behavior Therapy for Persistent Insomnia
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., & Buysse, D. J. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.1.5 · Cited by 863 · cited 1×
“Three meta-analyses reporting effect sizes found reliable improvements in sleep parameters using hypnotics in patients with chronic insomnia.(12,14,15) Holbrook et al.”
BackgroundPrevalence, burden, and treatment of insomnia in primary care
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.10.1417 · Cited by 694
Meta-analysis of benzodiazepine use in the treatment of insomnia.
(2000) · PubMed Central · Cited by 613
The Science of Reviewing Researcha
OXMAN, A. D., & GUYATT, G. H. (1993) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1993.tb26342.x · Cited by 472
Medical and socio-professional impact of insomnia
Léger, D., Guilleminault, C., Bader, G., Lévy, E., & Paillard, M. (2002) · Sleep · doi:10.1093/sleep/25.6.621 · Cited by 468
Evaluation of Chronic Insomnia
Sateia, M. J., Doghramji, K., Hauri, P. J., & Morin, C. M. (2000) · Sleep · doi:10.1093/sleep/23.2.1l · Cited by 466
Benzodiazepines and Zolpidem for Chronic Insomnia: A Meta-analysis of Treatment Efficacy
Nowell, P. D. (1997) · JAMA · doi:10.1001/jama.1997.03550240060035 · Cited by 451
The morbidity of insomnia uncomplicated by psychiatric disorders
Weissman, M. M., Greenwald, S., Niño-Murcia, G., & Dement, W. C. (1997) · General Hospital Psychiatry · doi:10.1016/s0163-8343(97)00056-x · Cited by 415 · cited 1×
“Growing evidence suggests that chronic, unremitting insomnia may predispose individuals to the development of psychiatric disorders and lead to substantial economic burden.(2,8,9) Treatment options for chronic insomnia include pharmacological agents and non-pharmacological agents.”
BackgroundMonjan, Simonsick, & Wallace (1999) · SLEEP · Cited by 402
Epidemiological Study on Insomnia in the General Population
Ohayon, M. (1996) · Sleep · doi:10.1093/sleep/19.suppl_3.s7 · Cited by 401
An American Academy of Sleep Medicine Review
Sateia, M. J., Doghramji, K., Hauri, P., & Morin, C. M. (2000) · Cited by 369
Practice Parameters for the Evaluation of Chronic Insomnia
Chesson, A. L., Hartse, K. M., Anderson, W. M., Davila, D., Johnson, S. F., Littner, M. R., Wise, M. S., & Rafecas, J. (2000) · SLEEP · doi:10.1093/sleep/23.2.1k · Cited by 332
Foley, D. J., Monjan, A. A., Simonsick, E. M., Wallace, R. B., & Blazer, D. G. (1999) · PubMed · Cited by 253
Ten-Year Trends in the Pharmacological Treatment Of Insomnia
Reid1, K., & Dawson, D. (1999) · SLEEP · doi:10.1093/sleep/22.3.371 · Cited by 189
Dundar, Y., Dodd, S. R., Strobl, J., Boland, A., Dickson, R., & Walley, T. (2004) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.594 · Cited by 168
Soldatos, C. R., Dikeos, D. G., & Whitehead, A. (1999) · International Clinical Psychopharmacology · doi:10.1097/00004850-199909000-00004 · Cited by 154
Buscemi, N., Vandermeer, B., Friesen, C., Bialy, L. M., Tubman, M., Ospina, M. B., Klassen, T. P., & Witmans, M. (2005) · PsycEXTRA Dataset · doi:10.1037/e439752005-001 · Cited by 134
Tolerance and rebound insomnia with rapidly eliminated hypnotics
Soldatos, C. R., Dikeos, D. G., & Whitehead, A. (1999) · International Clinical Psychopharmacology · doi:10.1097/00004850-199914050-00004 · Cited by 125
Prospective Data on Sleep Complaints and Associated Risk Factors in an Older Cohort
ROBERTS, R. E., Shema, S. J., & Kaplan, G. A. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199903000-00011 · Cited by 111
The Costs of Benzodiazepine-Associated Hospital-Treated Fall Injuries in the EU: A Pharmo Study
Panneman, M. J. M., Goettsch, W., Kramarz, P., & Herings, R. M. C. (2003) · Drugs & Aging · doi:10.2165/00002512-200320110-00004 · Cited by 89
The treatment of sleep disorders of older people.
(1990) · PubMed · Cited by 43
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.
Cited by
Sorted by citations
European guideline for the diagnosis and treatment of insomnia
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia‐Borreguero, D., Gjerstad, M., Gonçalves, M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12594 · Cited by 2,049
Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6470 · Cited by 1,519
Morin, C. M., & Benca, R. (2012) · The Lancet · doi:10.1016/s0140-6736(11)60750-2 · Cited by 976
The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023
Riemann, D., Espie, C. A., Altena, E., Arnardottir, E. S., Baglioni, C., Bassetti, C. L. A., Bastien, C., Berzina, N., Bjorvatn, B., Dikeos, D., et al. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14035 · Cited by 834
Benzodiazepine Use in the United States
Olfson, M., King, M., & Schoenbaum, M. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.1763 · Cited by 786
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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