{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:46:20Z","timestamp":1792813580303,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Several professional societies have provided recommendations for prescribing medications for insomnia. None has provided an integrative analysis that concurrently quantifies safety and efficacy (e.g., risk\u2013benefit ratios). This represents an important gap for informing clinician decision\u2010making. Accordingly, the aim of the present review is to provide such an analysis for five classes of sleep\u2010promoting medications. Adverse event data values were extracted from the most recent FDA\u2010approved package inserts and converted to an integer before being placebo\u2010adjusted and standardized as a rate per 1000 (AEr). Efficacy data, pre\u2010to\u2010post self\u2010reported data for active and placebo conditions were acquired from pivotal trials identified in \u201cwhite papers\u201d and systematic reviews\/meta\u2010analyses. Weighted effect sizes were calculated for subjective sleep latency, wake time after sleep onset and total sleep time, and then were averaged by medication class for each sleep continuity variable. Overall efficacy was represented by a single variable, SWT (sleep latency\u2009+\u2009wake time after sleep onset\u2009+\u2009total sleep time). Risk\u2013benefit was represented using a simple ratio value. For safety, it was found that melatonin receptor agonists had the lowest adverse event rate (AEr\u2009=\u200943.1), and non\u2010benzodiazepine benzodiazepine receptor agonists had the highest rate (AEr\u2009=\u2009255.0). For efficacy, it was found that the pre\u2010to\u2010post placebo adjusted effect sizes were largest for benzodiazepines (effect size\u2009=\u20091.94) and smallest for melatonin receptor agonists (effect size\u2009=\u20090.109). For risk\u2013benefit, histamine antagonist had the most favourable profile (risk\u2013benefit\u2009=\u200969.5), while melatonin receptor agonist had the least favourable profile (risk\u2013benefit\u2009=\u2009395.7). Overall, the combined metric for risk\u2013benefit suggests that treatment with a histamine antagonist is optimal and potentially represents the best first\u2010line therapy for the medical management of insomnia.<\/jats:p>","DOI":"10.1111\/jsr.14088","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T02:38:00Z","timestamp":1701225480000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparative short\u2010term safety and efficacy of hypnotics: A quantitative risk\u2013benefit analysis"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6341-5594","authenticated-orcid":false,"given":"Janet M. 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