Evidence map›Paper›PMID 25168785›Full record

SynthesisCNS drugs2014

Drug treatment of primary insomnia: a meta-analysis of polysomnographic randomized controlled trials.

Alexander Winkler, Charlotte Auer, Bettina K Doering, Winfried Rief

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in CNS drugs, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 11 pooled it
10.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 11 syntheses or guidelines pooled it, 141 citations in OpenAlex.

  1. Pooled it
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  9. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017
    Guideline
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  13. The efficacy and safety of zolpidem and zopiclone to treat insomnia in Alzheimer's disease: a randomized, triple-blind, placebo-controlled trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022
    Trial
  14. Sublingual and oral zolpidem for insomnia disorder: a 3-month randomized trial.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2020
    Trial
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  20. Toward personalized care for insomnia in the US Army: development of a machine-learning model to predict response to pharmacotherapy.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Alexander WinklerDepartment of Clinical Psychology and Psychotherapy, University of Marburg, Gutenbergstraße 18, 35032, Marburg, Germany, Alexander.Winkler@staff.uni-marburg.de.
Charlotte Auer
Bettina K Doering
Winfried Rief
Philipps University of Marburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextAlthough insomnia is a frequent health complaint that is often treated with drugs, little is known about differences in treatment efficacy of various drug classes on objective versus subjective outcome measures.

objectiveOur aim was to compare treatment efficacy of classical benzodiazepines, benzodiazepine receptor agonists (zopiclone, zolpidem and zaleplon), antidepressants (including low-dose doxepin), neuropeptides, progesterone receptor antagonists, hormones, melatonin receptor agonists, antihistamines, antiepileptics, and narcotics addressing primary insomnia. DATA SOURCES: We conducted a comprehensive literature search (up to 5 April 2013) using PubMed, Cochrane Clinical Trials, PQDT OPEN, OpenGREY, ISI Web of Knowledge, PsycINFO, PSYNDEX, and the WHO International Clinical Trials Registry Platform. ELIGIBILITY CRITERIA: Only polysomnographic, parallel-group, randomized controlled drug trials were included; eligibility was determined by two independent authors. DATA SYNTHESIS: We used a random effects model, based on 31 studies reporting 80 treatment conditions, covering 3,820 participants.

resultsEffect size estimates for the total sample of pooled drug classes suggest that there is a small-to-moderate, significant, and robust effect for objective outcomes (sleep onset latency g = -0.36, total sleep time g = 0.27) and subjective outcomes (sleep onset latency g = -0.24, total sleep time g = 0.21). Results indicate higher effect sizes for benzodiazepine receptor agonists and classical benzodiazepines compared with antidepressants (including low-dose doxepin) and for classical benzodiazepines compared with benzodiazepine receptor agonists. Benzodiazepine receptor agonists demonstrated higher effect sizes for objective outcomes. LIMITATIONS: Data on drug safety were not analyzed.

conclusionsFuture studies should use objective and subjective assessment. Focusing on efficacy, clinicians should favor benzodiazepine receptor agonists and classical benzodiazepines over antidepressants (including low-dose doxepin) for primary insomnia treatment, but the additional consideration of different side effect profiles can lead to alternative treatment decisions.

Indexed as

HumansPolysomnographyRandomized Controlled Trials as TopicSleep Initiation and Maintenance Disorders

Identifiers

PMID25168785
OpenAlexW2021124523

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.