Nguyen Patrick Viet-Quoc , Dang-Vu Thien Thanh , Leduc Philippe (candidate) , Champagne Sebastien , Saidi Lidia (student) , Desmarais Philippe
{"title":"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","authors":"Nguyen Patrick Viet-Quoc , Dang-Vu Thien Thanh , Leduc Philippe (candidate) , Champagne Sebastien , Saidi Lidia (student) , 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 <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.</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":"{\"title\":\"Effect of age on hypnotics’ efficacy and safety in insomnia: A systematic review and meta-analysis\",\"authors\":\"Nguyen Patrick Viet-Quoc , Dang-Vu Thien Thanh , Leduc Philippe (candidate) , Champagne Sebastien , Saidi Lidia (student) , 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 <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.</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}","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}
Effect of age on hypnotics’ efficacy and safety in insomnia: A systematic review and meta-analysis
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.
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.