Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence

While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medications, as it relates to the evidence supporting...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-02, Vol.12 (4), p.1629
Main Authors: Zee, Phyllis C, Bertisch, Suzanne M, Morin, Charles M, Pelayo, Rafael, Watson, Nathaniel F, Winkelman, John W, Krystal, Andrew D
Format: Article
Language:English
Subjects:
Benzodiazepines
Clinical medicine
Dosage and administration
Drug therapy
Evaluation
Evidence-based medicine
Hypnotics
Insomnia
Literature reviews
Medical personnel
Nurse practitioners
Patient outcomes
Polls & surveys
Response rates
Review
Sedatives
Sleep
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Summary:While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medications, as it relates to the evidence supporting the focus statement, "No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time". The panelists' assessment was also compared to findings from a national survey of practicing physicians, psychiatrists, and sleep specialists. Survey respondents revealed a wide range of opinions regarding the appropriateness of using the US Food and Drug Administration (FDA)-approved medications for the treatment of insomnia lasting more than 3 weeks. After discussion of the literature, the panel unanimously agreed that some classes of insomnia medications, such as non-benzodiazepines hypnotics, have been shown to be effective and safe for long-term use in the appropriate clinical setting. For eszopiclone, doxepin, ramelteon and the newer class of dual orexin receptor antagonists, the FDA label does not specify that their use should be of a limited duration. Thus, an evaluation of evidence supporting the long-term safety and efficacy of newer non-benzodiazepine hypnotics is timely and should be considered in practice recommendations for the duration of pharmacologic treatment of chronic insomnia.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12041629