SynthesisJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2009
Meta-analyses of hypnotics and infections: eszopiclone, ramelteon, zaleplon, and zolpidem.
Synthesis in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Eszopiclone for insomnia.The Cochrane database of systematic reviews · 2018Pooled it
- Z-Drug Use and All-Cause Mortality: A Meta-Analysis of Observational Cohort Studies.Neuropsychiatric disease and treatment · 2026Article
- Article
- Mechanisms of sleep disturbances in long-term cancer survivors: a childhood cancer survivor study report.JNCI cancer spectrum · 2024Article
- Hypnotics and infections: disproportionality analysis of the U.S. Food & Drug Administration adverse event reporting system database.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Association between benzodiazepine receptor agonist use and mortality in patients hospitalised for COVID-19: a multicentre observational study.Epidemiology and psychiatric sciences · 2022Observational
- Article
- Non-benzodiazepine hypnotic use for sleep disturbance in people aged over 55 years living with dementia: a series of cohort studies.Health technology assessment (Winchester, England) · 2021Article
- Efficacy and Safety of Banxia Formulae for Insomnia: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials.Evidence-based complementary and alternative medicine : eCAM · 2021Review
- Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study.BMC medicine · 2020Article
- The Sleep-Immune Crosstalk in Health and Disease.Physiological reviews · 2019Review
- Use of Sedative-Hypnotics and Mortality: A Population-Based Retrospective Cohort Study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018Article
- Use of Hypnotics and Risk of Cancer: A Meta-Analysis of Observational Studies.Korean journal of family medicine · 2018Article
- Translating Benzodiazepine Utilization Data into Meaningful Population Exposure: Integration of Two Metrics for Improved Reporting.Clinical drug investigation · 2018Article
- Benzodiazepines and Z-Drugs: An Updated Review of Major Adverse Outcomes Reported on in Epidemiologic Research.Drugs in R&D · 2017Review
- What do hypnotics cost hospitals and healthcare?F1000Research · 2017Article
- The Risk of Pneumonia in Older Adults Using Nonbenzodiazepine Hypnotics.Journal of managed care & specialty pharmacy · 2016Observational
- Mortality Risk of Hypnotics: Strengths and Limits of Evidence.Drug safety · 2016Review
- Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit.F1000Research · 2016Review
- Zolpidem Use Associated With Increased Risk of Pyogenic Liver Abscess: A Case-Control Study in Taiwan.Medicine · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesRecent meta-analyses raising concern about risks of hypnotics suggest a need for more clarification of these risks.
methodsBecause of preliminary suggestions that eszopiclone causes infections, we studied US Food and Drug Administration files on the 4 most-recently approved hypnotics, combined with published studies, to compile the risk ratios of infections for groups randomly assigned to receive hypnotics versus those assigned to receive placebos in controlled trials. Parallel controlled clinical trials of eszopiclone, ramelteon, zaleplon, and zolpidem were included when data on subjects, duration of exposure, and adverse effects were available. Results of trials were combined by meta-analyses.
resultsOf 8828 participants assigned to the 4 hypnotics and 4383 participants who randomly received placebos, 606 in the hypnotics groups and 200 in the placebo groups were reported to develop some kind of infection (risk ratio = 1.44, 95% confidence interval 1.25-1.64, p < 0.00001). Most infections were apparently mild and did not lead to dropouts. Subanalyses for individual drugs indicated that eszopiclone and zolpidem individually were associated with reported infections. There were insufficient data concerning individual studies of zaleplon and ramelteon for valid secondary meta-analyses of zaleplon or ramelteon by themselves.
conclusionsResearch is needed to objectively determine whether the use of hypnotics increases the risk of infections. Immune compromise or esophageal reflux and aspiration should be studied as possible mechanisms.
Indexed as
Identifiers
19968019PMC2725260W147714449What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.