Insomnia is a serious health problem that affects millions of people. Treatment involves behavioral changes, such as minimizing daily habits that interfere with sleep, and pharmacotherapy. The newer drugs for insomnia differ from each other in their pharmacokinetics, which could be expected to affect different aspects of insomnia. For example, drugs with a shorter half-life might be effective for sleep latency but less effective for sleep duration. The purpose of this review is to compare the effectiveness and harms of these newer drugs for treatment of insomnia.

Contents

• Introduction
  • Scope and Key Questions
  • Included populations
  • Included interventions
  • Included outcomes
• Methods
  • Literature Search
  • Study Selection
  • Data Abstraction
  • Validity Assessment
  • Data Synthesis
• Results
  • Overview of included studies
  • Key Questions 1 and 2. What is the comparative effectiveness, safety, and tolerability of newer drugs in treating adults and children with insomnia?
  • Summary of the Evidence
  • Detailed Assessment
  • Next-day effects
  • Zolpidem extended release vs other newer drugs for insomnia
  • Key Question 3. Are there subgroups of patients based on demographics (age, racial groups, gender), other medications, or co-morbidities for which one newer insomnia drug is more effective or associated with fewer adverse events?
  • Summary of the Evidence
  • Detailed Assessment
  • Overall Summary
• References
• Appendixes
  • Appendix A. Literature search strategies
  • Appendix B. Quality assessment methods for drug class reviews for the Drug Effectiveness Review Project
  • Appendix C. Excluded Trials
  • Appendix D. Summary of results of trials of newer insomnia drugs versus benzodiazepines
• Evidence Tables

The funding source, the Center for Evidence-based Policy, is supported by 17 organizations, including 15 state Medicaid programs. These organizations selected the topic and had input into the Key Questions for this review. The content and conclusions of the review are entirely determined by the Evidence-based Practice Center researchers. The authors of this report have no financial interest in any company that makes or distributes the products reviewed in this report.

Suggested citation:

Carson S, Yen P-Y, McDonagh MS. Drug Class Review on Newer Drugs for Insomnia. 2006. http://www.ohsu.edu/drugeffectiveness/reports/final.cfm

The Agency for Healthcare Research and Quality has not yet seen or approved this report.

The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.