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Clonazepam for the management of sleep disorders

Background The objectives of this review and meta-analysis of polysomnographic data are those to focus on the clinical use of clonazepam for the management of sleep disorders by re-analyzing clinical trials and randomized clinical trials which have been published in peer-reviewed journals. Methods A...

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Published in:Neurological sciences 2023, Vol.44 (1), p.115-128
Main Authors: Raggi, Alberto, Mogavero, Maria Paola, DelRosso, Lourdes M., Ferri, Raffaele
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DelRosso, Lourdes M.
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description Background The objectives of this review and meta-analysis of polysomnographic data are those to focus on the clinical use of clonazepam for the management of sleep disorders by re-analyzing clinical trials and randomized clinical trials which have been published in peer-reviewed journals. Methods A review of the literature including clinical trials and randomized controlled trials was performed in PubMed®, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. A random effects model meta-analysis was then carried out for the four more frequently reported polysomnographic measures: total sleep time, sleep latency, sleep efficiency, and periodic leg movement during sleep (PLMS) index. Results A total of 33 articles were retrieved and screened in full text, of which 18 met the criteria for review; among the latter, nine met the criteria for meta-analysis. The studies included in the review involved patients with insomnia, REM sleep behavior disorder, sleep bruxism, and restless leg syndrome or PLMS which reported, most often, an increase in total sleep time with clonazepam. A clear sleep-promoting effect of clonazepam was found also by meta-analysis. Discussion and conclusions Our results indicate that the pharmacological treatment of sleep disorders with clonazepam must always be personalized according to the type of patient, the risk of addiction and the concomitant presence of respiratory disorders are key factors to take into account. However, in light of the clinical evidence of the few studies in the literature on the different types of disorders, more studies on the use of clonazepam (also in association with first choice treatments) are definitely needed.
doi_str_mv 10.1007/s10072-022-06397-x
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Methods A review of the literature including clinical trials and randomized controlled trials was performed in PubMed®, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. A random effects model meta-analysis was then carried out for the four more frequently reported polysomnographic measures: total sleep time, sleep latency, sleep efficiency, and periodic leg movement during sleep (PLMS) index. Results A total of 33 articles were retrieved and screened in full text, of which 18 met the criteria for review; among the latter, nine met the criteria for meta-analysis. The studies included in the review involved patients with insomnia, REM sleep behavior disorder, sleep bruxism, and restless leg syndrome or PLMS which reported, most often, an increase in total sleep time with clonazepam. A clear sleep-promoting effect of clonazepam was found also by meta-analysis. Discussion and conclusions Our results indicate that the pharmacological treatment of sleep disorders with clonazepam must always be personalized according to the type of patient, the risk of addiction and the concomitant presence of respiratory disorders are key factors to take into account. However, in light of the clinical evidence of the few studies in the literature on the different types of disorders, more studies on the use of clonazepam (also in association with first choice treatments) are definitely needed.</description><identifier>ISSN: 1590-1874</identifier><identifier>EISSN: 1590-3478</identifier><identifier>DOI: 10.1007/s10072-022-06397-x</identifier><identifier>PMID: 36112279</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Addictions ; Benzodiazepines ; Clinical trials ; Clonazepam ; Clonazepam - pharmacology ; Clonazepam - therapeutic use ; Drug therapy ; Humans ; Latency ; Leg ; Literature reviews ; Medicine ; Medicine &amp; Public Health ; Meta-analysis ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Patients ; Polysomnography - methods ; Psychiatry ; REM sleep ; Restless Legs Syndrome - complications ; Review Article ; Sleep ; Sleep disorders</subject><ispartof>Neurological sciences, 2023, Vol.44 (1), p.115-128</ispartof><rights>Fondazione Società Italiana di Neurologia 2022. 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Fondazione Società Italiana di Neurologia.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c305t-d1a960a88b79309357f7b04422a602d0ac10a4488a0408a9f0411944e2702ae23</citedby><cites>FETCH-LOGICAL-c305t-d1a960a88b79309357f7b04422a602d0ac10a4488a0408a9f0411944e2702ae23</cites><orcidid>0000-0001-9414-1995</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36112279$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raggi, Alberto</creatorcontrib><creatorcontrib>Mogavero, Maria Paola</creatorcontrib><creatorcontrib>DelRosso, Lourdes M.</creatorcontrib><creatorcontrib>Ferri, Raffaele</creatorcontrib><title>Clonazepam for the management of sleep disorders</title><title>Neurological sciences</title><addtitle>Neurol Sci</addtitle><addtitle>Neurol Sci</addtitle><description>Background The objectives of this review and meta-analysis of polysomnographic data are those to focus on the clinical use of clonazepam for the management of sleep disorders by re-analyzing clinical trials and randomized clinical trials which have been published in peer-reviewed journals. 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subjects Addictions
Benzodiazepines
Clinical trials
Clonazepam
Clonazepam - pharmacology
Clonazepam - therapeutic use
Drug therapy
Humans
Latency
Leg
Literature reviews
Medicine
Medicine & Public Health
Meta-analysis
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Patients
Polysomnography - methods
Psychiatry
REM sleep
Restless Legs Syndrome - complications
Review Article
Sleep
Sleep disorders
title Clonazepam for the management of sleep disorders
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