Background

This study focuses on seven commonly used hypnotics to comprehensively analyze the effects of long- and short-term use on sleep outcomes among adults and older adults.

Methods

A network meta-analysis was performed. The insomnia medications were classified into seven categories: benzodiazepines, z-drugs, melatonin, H1-antagonists, orexin receptor antagonists (ORAs), antidepressants, and anticonvulsants. We compared their efficacy of total sleep time, sleep latency, sleep efficiency and wake after sleep onset in subgroups short-term, long-term, elderly, and adults.

Results

A total of 111 RCTs involving 25,923 participants were included in this study.

Conclusions

ORAs can be widely used in adults and the elderly, and both short-term and long-term use are effective for primary insomnia. H1-antagonists are more effective in adults than in the elderly. Although benzodiazepines have a more obvious effect on sleep maintenance, it is best to reduce their use due to their side effects, especially for the elderly. As a food supplement, melatonin has little effect on adults, but it still has a certain effect on the elderly.

中文翻译：

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成人和老年人睡眠药物长期和短期疗效的网络荟萃分析

背景

本研究重点关注七种常用催眠药，以综合分析长期和短期使用对成人和老年人睡眠结果的影响。

方法

进行了网络荟萃分析。失眠药物分为七类：苯二氮卓类药物、z-药物、褪黑激素、H1-拮抗剂、食欲素受体拮抗剂（ORA）、抗抑郁药和抗惊厥药。我们比较了它们在短期、长期、老年人和成人亚组中的总睡眠时间、睡眠潜伏期、睡眠效率和入睡后觉醒的功效。

结果

本研究共纳入 111 项 RCT，涉及 25,923 名参与者。

结论

ORA可广泛用于成人和老年人，短期和长期使用均对原发性失眠有效。H1-拮抗剂对成人比对老年人更有效。苯二氮卓类药物虽然对维持睡眠有较明显的效果，但由于其副作用，最好减少使用，尤其是老年人。褪黑素作为食品补充剂，对成年人的作用不大，但对老年人还是有一定作用的。