Are prescribed medications effective in the treatment of insomnia complaints?

Ohayon, Maurice M.; Caulet, M.; Arbus, L.; Billard, Marcel; Coquerel, Antoine; Guieu, J.D.; Kullmann, B.; Laffont, F; Lemoine, P.; Paty, J; Pechadre, J. C.; Vecchierini, Marie-Françoise; Vespignani, H.

doi:10.1016/s0022-3999(98)00079-8

Cited by 64 publications

(26 citation statements)

References 22 publications

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“…By far the most commonly prescribed hypnotic drugs are the benzodiazepinelike hypnotics (zopiclone, zolpidem and zaleplone, referred to below as z-hypnotics). One study reported about 50% of all prescribed hypnotics to be zopiclone (Kassam et al, 2006), and another study reported that zolpidem accounted for 11% of all sleep promoting drugs prescribed and zopiclone for 9% (Ohayon et al, 1999). Use of z-hypnotics increases considerably with age and concomitant somatic or psychiatric disease (Hausken et al, 2009;Kassam et al, 2006;Ohayon et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

“…One study reported about 50% of all prescribed hypnotics to be zopiclone (Kassam et al, 2006), and another study reported that zolpidem accounted for 11% of all sleep promoting drugs prescribed and zopiclone for 9% (Ohayon et al, 1999). Use of z-hypnotics increases considerably with age and concomitant somatic or psychiatric disease (Hausken et al, 2009;Kassam et al, 2006;Ohayon et al, 1999). Because of the short terminal half-lives (compared to benzodiazepines), few negative effects on daytime vehicle driving would be expected from the use of z-hypnotics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impairment related to blood drug concentrations of zopiclone and zolpidem compared to alcohol in apprehended drivers

Gustavsen

Al-Sammurraie

Mørland

et al. 2009

Accident Analysis & Prevention

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impairment related to blood drug concentrations of zopiclone and zolpidem compared to alcohol in apprehended drivers

Gustavsen

Al-Sammurraie

Mørland

et al. 2009

Accident Analysis & Prevention

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“…The effectiveness of nonpharmacological treatment programs for insomniac patients, focusing on insomnia complaints on the one hand, and on stress management and problem-solving on the other, has been proven in several studies [7,19,20,23]. Specialized treatment programs for insomniac patients may improve the quality of insomnia treatment in the health care system and change the attitude of general practitioners, who often regard drug prescription, especially of benzodiazepines, as the treatment of first choice despite chronic insomnia [5,22]. Therefore, special training programs [16] on the diagnosis and treatment of insomnia for students and practitioners of medicine and psychology should include psychosocial aspects of insomnia.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial aspects of insomnia

Käppler

Hohagen

2003

European Archives of Psychiatry and Clinical Neuroscience

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The relationship between insomnia and psychosocial factors is focused only in few epidemiological studies. Furthermore, most of them do not control for the mutual interdependencies of variables like age, sex, psychosocial distress and somatic or psychiatric disorders in their relation to insomnia. From a sample of general practice attendants, 516 patients with different grades of insomnia diagnosed according to DSM criteria were selected. Logistic regression analysis revealed seven psychosocial factors with independent predictive value for the occurrence of insomnia: increased age, conflicts with relatives, professional overload, housekeeping overload, illness of relatives, social and psychiatric status. Based on such a risk profile, in more than 2/3 of the cases the presence of insomnia can be predicted correctly. Consequences for diagnostic training and multimodal treatment programs are suggested.

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“…[30][31][32][33][34][35][36] Only 2 prior studies have examined effectiveness. 37,38 Neither study distinguished between sleep complaints and insomnia disorder and, as such, response to treatment and remission from the disorder could not be extricated. Vital information on the dose and pattern of prescription sleep aid use was missing from both studies.…”

Section: Introductionmentioning

confidence: 96%

Effectiveness of Benzodiazepine Receptor Agonists in the Treatment of Insomnia: An Examination of Response and Remission Rates

Pillai

Roth

Roehrs

et al. 2016

Sleep

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Study objectives:To examine the real-world effectiveness of benzodiazepine receptor agonists (BzRAs) by quantifying response and remission rates in a clinical sample receiving chronic BzRA treatment for insomnia. Methods: Participants were outpatients (N = 193; 72% female; 55.2 ± 11.1 year) who had an insomnia diagnosis per medical records, and who were taking a therapeutic dose of BzRA for their insomnia. Endpoints were nocturnal sleep disturbance and Insomnia Severity Index (ISI) scores. A reduction meeting the criterion for the minimally important difference in ISI scores (change ≥ 6) constituted "response"; "remission" was inferred when symptoms fell below the clinical cutoff (ISI < 11). Results: Most participants (71%) used BzRAs at least 5 nights per week. Mean ISI scores were significantly lower (t = 22.31; p < .01) while on BzRAs than when untreated, but remained in the clinical range (mean = 11.0; standard deviation = 5.7). Although 76.7% responded to treatment, only 47.7% remitted. The majority (68.9%) of participants had a sleep-onset latency > 30 minutes and/or wake-time after sleep onset > 60 minutes while on BzRAs. After controlling for gender and insomnia severity when untreated, odds of insomnia persistence despite BzRA use were 2 times higher in patients with comorbid medical [odds ratio (OR) = 2.39; 95% confidence interval (CI) = 1.20% to 4.77%; p < .05] and psychiatric disorders (OR = 2.24; 95% CI = 1.21% to 4.13%; p < .05). Conclusions: This is the first study to distinguish between response and remission in insomnia patients taking BzRAs. Findings suggest that while many insomnia patients respond to chronic BzRA treatment, most do not remit. Remission rates are particularly low for comorbid insomnia, the most prevalent phenotype of the disorder.

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Are prescribed medications effective in the treatment of insomnia complaints?

Cited by 64 publications

References 22 publications

Impairment related to blood drug concentrations of zopiclone and zolpidem compared to alcohol in apprehended drivers

Impairment related to blood drug concentrations of zopiclone and zolpidem compared to alcohol in apprehended drivers

Psychosocial aspects of insomnia

Effectiveness of Benzodiazepine Receptor Agonists in the Treatment of Insomnia: An Examination of Response and Remission Rates

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