A network meta-analysis of the long- and short-term efficacy of sleep medicines in adults and older adults

• Published in: Neuroscience and biobehavioral reviews Vol. 131; pp. 489 - 496
• Main Authors: Wang, Lu, Pan, Yundan, Ye, Chunyan, Guo, Lizhe, Luo, Sumei, Dai, Sisi, Chen, Na, Wang, E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.12.2021
• Subjects: Aged; Antidepressive Agents - therapeutic use; Benzodiazepines; H1-antagonist; Humans; Hypnotics and Sedatives - pharmacology; Hypnotics and Sedatives - therapeutic use; Insomnia; Melatonin; Network Meta-Analysis; Orexin receptor antagonists; Sleep; Sleep Initiation and Maintenance Disorders - drug therapy; Z-drugs; RCT; Melatonin; NMA; H1-antagonist; SUCRA; BZD; WASO; Benzodiazepines; ORAs; Z-drugs; SE; Orexin receptor antagonists; CBT; TST; Insomnia; MD; SL
• ISSN: 0149-7634; 1873-7528
• DOI: 10.1016/j.neubiorev.2021.09.035

•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. 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. 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. A total of 111 RCTs involving 25,923 participants were included in this study. 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.