Comparative efficacy and acceptability of pharmacological treatments for insomnia in adults: a systematic review and network meta-analysis

Franco De Crescenzo,Cinzia Del Giovane,Corrado Barbui,Marco Ciabattini,Andrea Cipriani,Francesca Foti,Laura Amato,Norio Watanabe,Monica Sañé Schepisi,Digby J Quested

doi:10.1002/14651858.cd012364

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows: 1) To compare individual pharmacological treatments for insomnia in adults in terms of: efficacy, measured as self-rated quality of sleep or satisfaction with sleep; and acceptability of treatment. 2) To generate a clinically-useful hierarchy of available pharmacological treatments for insomnia in adults, according to their efficacy and acceptability.

Highlights

Insomnia is characterised by difficulty in initiating and maintaining sleep, by early morning awakenings and by non-restorativeComparative efficacy and acceptability of pharmacological treatments for insomnia in adults: a systematic review and network metasleep, which leads to a condition of daytime blunting
Our intention is to reduce the uncertainty about the efficacy of treatments due to the limited number of direct comparisons as reported in previous standard meta-analyses, and provide an evidence-based hierarchy of the comparative efficacy and acceptability of the drugs approved for the treatment of primary insomnia
The present review will synthesise the best available clinical evidence, including both direct and indirect comparisons, in order to help clinicians and patients to make informed decisions on the best pharmacological treatments approved for insomnia in terms of efficacy and acceptability

Summary

BACKGROUND

Insomnia is characterised by difficulty in initiating and maintaining sleep, by early morning awakenings and by non-restorative. Doxepin has been demonstrated to be effective for sleep maintenance and early morning awakenings, which are the most common insomnia-related complaints in the elderly (Krystal 2010) Melatonin receptor agonists, such as melatonin and ramelteon, have been demonstrated to be a well-tolerated option for the treatment of patients with insomnia characterised by difficulty in sleep onset (Simpson 2008). Our intention is to reduce the uncertainty about the efficacy of treatments due to the limited number of direct comparisons as reported in previous standard meta-analyses, and provide an evidence-based hierarchy of the comparative efficacy and acceptability of the drugs approved for the treatment of primary insomnia This network meta-analysis will help clinicians, patients and policy makers to make informed decisions on the best pharmacological treatments for insomnia. The present review will synthesise the best available clinical evidence, including both direct and indirect comparisons, in order to help clinicians and patients to make informed decisions on the best pharmacological treatments approved for insomnia in terms of efficacy and acceptability

OBJECTIVES

METHODS

Findings

Methods for indirect and mixed comparisons