Zolpidem is widely used to treat insomnia of older adults despite that few randomized controlled studies were conducted in this group. We systematically reviewed the relevant literature on efficacy/effectiveness and safety of zolpidem use by elderly individuals in relevant databases completed with a manual search of key journals. Studies were required to include individuals aged ≥60 years under intervention with zolpidem compared to placebo or other hypnosedatives. Outcomes were either objectively- or subjectively-assessed improvements in specific sleep parameters and safety for clinical use. The 31 reports selected for review were mostly of low-quality. The evidence suggests that zolpidem is useful typically by reducing sleep latency and episodes of wake after sleep onset, and increasing total sleep time and sleep efficiency. Regarding safety and tolerability, analyses suggest a low risk of daytime sleepiness and of deleterious effects on memory or psychomotor performance, provided that recommended dosage and precautions are followed. Few retrospective studies associate zolpidem use with risk of falls, fractures, dementia, cancer, and stroke. Zolpidem appears effective at lower doses and for short-term treatment among the elderly. Rigorous, new clinical trials are warranted to further document the specific effects of zolpidem in older individuals.

中文翻译：

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四分之一世纪以上最处方的安眠药：老年人对唑吡坦的系统评价。

尽管该组很少进行随机对照研究，但唑吡坦被广泛用于治疗老年人的失眠症。我们在相关数据库中系统地审查了有关老年人使用唑吡坦的疗效/有效性和安全性的相关文献，并通过手动搜索关键期刊来完成。与安慰剂或其他催眠药相比，接受唑吡坦干预的年龄≥60岁的个体需要进行研究。结果是客观或主观评估特定睡眠参数和临床安全性的改善。选择进行审查的31份报告大多是低质量的。有证据表明，唑吡坦通常可通过减少睡眠潜伏期和睡眠发作后的醒来发作以及增加总睡眠时间和睡眠效率来发挥作用。关于安全性和耐受性，分析表明，如果遵循推荐的剂量和预防措施，则白天嗜睡和对记忆力或精神运动表现的有害影响的风险较低。很少有回顾性研究将唑吡坦的使用与跌倒，骨折，痴呆，癌症和中风的风险联系起来。唑吡坦似乎在老年人中以较低的剂量和短期治疗有效。有必要进行严格的新临床试验，以进一步证明唑吡坦对老年患者的特定作用。唑吡坦似乎在老年人中以较低的剂量和短期治疗有效。有必要进行严格的新临床试验，以进一步证明唑吡坦对老年患者的特定作用。唑吡坦似乎在老年人中以较低的剂量和短期治疗有效。有必要进行严格的新临床试验，以进一步证明唑吡坦对老年患者的特定作用。