Effect of age on hypnotics’ efficacy and safety in insomnia: A systematic review and meta-analysis

IF 3.8 2区 医学 Q1 CLINICAL NEUROLOGY
Nguyen Patrick Viet-Quoc , Dang-Vu Thien Thanh , Leduc Philippe (candidate) , Champagne Sebastien , Saidi Lidia (student) , Desmarais Philippe
{"title":"Effect of age on hypnotics’ efficacy and safety in insomnia: A systematic review and meta-analysis","authors":"Nguyen Patrick Viet-Quoc ,&nbsp;Dang-Vu Thien Thanh ,&nbsp;Leduc Philippe (candidate) ,&nbsp;Champagne Sebastien ,&nbsp;Saidi Lidia (student) ,&nbsp;Desmarais Philippe","doi":"10.1016/j.sleep.2024.11.023","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and meta-analysis evaluates the efficacy in improving sleep quality and safety of hypnotics in individuals aged 65 years or older compared to those under 65 years.</div></div><div><h3>Methods</h3><div>MEDLINE, EMBASE, Web of Science, and EBM Reviews were searched for randomized clinical trials comparing hypnotics to the placebo in adults with chronic insomnia between Jan 2000 and Dec 2022. The efficacy outcome included all participant self-assessments sleep quality questionnaires. The safety outcome included acceptability and tolerance. Standardized mean differences (SMD) was estimated using a random effect model.</div></div><div><h3>Results</h3><div>We included 17 and 53 clinical trials with 3688 and 14,720 participants in the ≥65 years and &lt;65 years group respectively. The SMD for the sleep quality outcome was −0.36 [Confidence interval (CI) 95 %: 0.45;-0.26] in the ≥65 years group compared to −0.51 [95%CI: 0.61; −0.41] in the &lt;65 years group (p = 0.02). Differences in efficacy were observed between pharmacological classes. The overall SMD for the tolerance outcome was - 0.25 [95%CI: 0.34; −0.16] favoring the placebo group (p &lt; 0.001). In the ≥65 years group the SMD was −0.07 [95%CI: 0.21; 0.08] compared to −0.31 [95%CI: 0.41; −0.21] in the &lt;65 years group (p = 0.01). There were no differences for acceptability.</div></div><div><h3>Conclusion</h3><div>We found that some hypnotics classes could be less effective in older individuals. We encourage authors to include details on multimorbidity and polypharmacy in their publications.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 120-127"},"PeriodicalIF":3.8000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945724005264","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective

This systematic review and meta-analysis evaluates the efficacy in improving sleep quality and safety of hypnotics in individuals aged 65 years or older compared to those under 65 years.

Methods

MEDLINE, EMBASE, Web of Science, and EBM Reviews were searched for randomized clinical trials comparing hypnotics to the placebo in adults with chronic insomnia between Jan 2000 and Dec 2022. The efficacy outcome included all participant self-assessments sleep quality questionnaires. The safety outcome included acceptability and tolerance. Standardized mean differences (SMD) was estimated using a random effect model.

Results

We included 17 and 53 clinical trials with 3688 and 14,720 participants in the ≥65 years and <65 years group respectively. The SMD for the sleep quality outcome was −0.36 [Confidence interval (CI) 95 %: 0.45;-0.26] in the ≥65 years group compared to −0.51 [95%CI: 0.61; −0.41] in the <65 years group (p = 0.02). Differences in efficacy were observed between pharmacological classes. The overall SMD for the tolerance outcome was - 0.25 [95%CI: 0.34; −0.16] favoring the placebo group (p < 0.001). In the ≥65 years group the SMD was −0.07 [95%CI: 0.21; 0.08] compared to −0.31 [95%CI: 0.41; −0.21] in the <65 years group (p = 0.01). There were no differences for acceptability.

Conclusion

We found that some hypnotics classes could be less effective in older individuals. We encourage authors to include details on multimorbidity and polypharmacy in their publications.
年龄对失眠症催眠药疗效和安全性的影响:系统回顾与荟萃分析
方法检索了2000年1月至2022年12月期间在MEDLINE、EMBASE、Web of Science和EBM Reviews上对患有慢性失眠症的成人进行的催眠药与安慰剂比较的随机临床试验。疗效结果包括所有参与者自我评估的睡眠质量问卷。安全性结果包括可接受性和耐受性。结果我们分别纳入了17项和53项临床试验,≥65岁组和65岁组分别有3688名和14720名参与者。睡眠质量结果的SMD在≥65岁组为-0.36[置信区间(CI)95%:0.45;-0.26],而在<65岁组为-0.51[95%CI:0.61;-0.41](P = 0.02)。不同药物类别之间的疗效存在差异。耐受性结果的总体SMD为-0.25 [95%CI: 0.34; -0.16],安慰剂组更优(p = 0.001)。≥65岁组的SMD为-0.07 [95%CI: 0.21; 0.08],而65岁组为-0.31 [95%CI: 0.41; -0.21](p = 0.01)。结论我们发现,某些类别的催眠药对老年人的疗效可能较差。我们鼓励作者在其出版物中详细介绍多病和多重用药情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Sleep medicine
Sleep medicine 医学-临床神经学
CiteScore
8.40
自引率
6.20%
发文量
1060
审稿时长
49 days
期刊介绍: Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信