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'Z' Drugs May Help Insomniacs Fall Asleep, but Effect Is Small — Physician’s First Watch

Medical News |
December 19, 2012

'Z' Drugs May Help Insomniacs Fall Asleep, but Effect Is Small

Nonbenzodiazepine hypnotics, the so-called "Z" drugs (eszopiclone, zaleplon, and zolpidem), are associated with only slight improvements in sleep latency, according to a meta-analysis in BMJ.

Researchers analyzed 13 trials submitted to the FDA in which 4400 patients with insomnia were randomized to a Z drug or placebo.

Relative to placebo, Z drugs decreased the amount of time it took participants to fall asleep by a mean of 22 minutes, judged by polysomnography. The subjective time it took participants to fall asleep was also lower in the drug group, but only by 7 minutes. Larger doses were associated with greater improvements.

The authors conclude that the size of this effect is small and "needs to be balanced with concerns about adverse effects, tolerance, and potential addiction. The placebo response accounted for about half of the drug response. This suggests that increased attention should be directed at psychological interventions for insomnia."

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