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Q In older persons with insomnia, what are the benefits and risks of short term use of sedative hypnotics?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Psychiatry ★★★★★★☆ Geriatrics ★★★★★★☆ Mental health ★★★★★☆☆
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Trials, and PsycLIT (1966–2003); bibliographies of published reviews; and 3 manufacturers of sedative hypnotics (unpublished studies).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, …