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Review: sedative hypnotics increase adverse effects more than they improve sleep quality in older persons with insomnia

Clinical impact ratings GP/FP/Primary care Psychiatry Geriatrics Mental health

Key Words: hypnotics and sedatives • sleep initiation and maintenance disorders

The first 150 words of the full text of this article appear below.

METHODS
Data sources Medline, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, and PsycLIT (1966–2003); bibliographies of published reviews; and 3 manufacturers of sedative hypnotics (unpublished studies).

Study selection and assessment English language randomised controlled trials (RCTs) that compared treatment with sedative hypnotics (prescription or over the counter drugs) for 5 consecutive nights with placebo or another active treatment in persons 60 years of age who met predetermined criteria for insomnia. Studies excluded patients with psychiatric disorders or severe or acute physical illness that could disrupt sleep, ensured that participants were cognitively able to complete the subjective outcome assessment, and included a washout period between drug treatments. Studies of barbiturates or chloral hydrate or derivatives were excluded. 24 RCTs (n = 2417, age range 56–98 y) met the selection criteria and had extractable data. Individual study quality was assessed using the Jadad criteria. 15 RCTs had quality scores 4 out of . . . [Full text of this article]

A Mark Clarfield, MD, FRCPC

Soroka Hospital, Ben-Gurion University, Beersheva, Israel