A network meta-analysis of the long- and short-term efficacy of sleep medicines in adults and older adults. (December 2021)

• Record Type: Journal Article
• Authors: Wang, Lu; Pan, Yundan; Ye, Chunyan; Guo, Lizhe; Luo, Sumei; Dai, Sisi; Chen, Na; Wang, E.
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 131(2021)
• Page Start: 489
• Page End: 496
• Publication Date: 2021-12
• Subjects: BZD benzodiazepines -- CBT cognitive behavioral therapy -- MD mean difference -- NMA Network meta-analysis -- ORAs orexin receptor antagonists -- RCT Randomized Controlled Trial -- SE sleep efficiency -- SL sleep latency -- SUCRA surface under the cumulative ranking curves -- TST total sleep time -- WASO wake after sleep onset; Insomnia -- Benzodiazepines -- Z-drugs -- H1-antagonist -- Melatonin -- Orexin receptor antagonists; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2021.09.035
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: We focuses on seven commonly used hypnotics to analyze the effects of long- and short-term use on adults and older adults. Main outcomes are total sleep time, sleep efficiency, sleep latency and WASO. ORAs can be widely used in adults and the elderly, and both short-term and long-term use are effective for primary insomnia. H1-antagonists are more effective in adults than in the elderly. As a food supplement, melatonin has little effect on adults, but it still has a certain effect on the elderly. Abstract: Background: This study focuses on seven commonly used hypnotics to comprehensively analyze the effects of long- and short-term use on sleep outcomes among adults and older adults. Methods: A network meta-analysis was performed. The insomnia medications were classified into seven categories: benzodiazepines, z-drugs, melatonin, H1-antagonists, orexin receptor antagonists (ORAs), antidepressants, and anticonvulsants. We compared their efficacy of total sleep time, sleep latency, sleep efficiency and wake after sleep onset in subgroups short-term, long-term, elderly, and adults. Results: A total of 111 RCTs involving 25, 923 participants were included in this study. Conclusions: ORAs can be widely used in adults and the elderly, and both short-term and long-term use are effective for primary insomnia. H1-antagonists are more effective in adults than in the elderly. Although benzodiazepines have a more obvious effect on sleep maintenance, it is best to reduce their use due to their side effects, especially for the elderly. As a food supplement, melatonin has little effect on adults, but it still has a certain effect on the elderly.