Background: Insomnia has become a major public health problem with significant social burden, which is associated with an increased risk of medical or mental disorders, including injury, non-alcoholic fatty liver disease, hypertension, cardiovascular diseases, dementia, depression, mortality from all-cause and cardiovascular diseases. Cognitive-behavioural treatment and pharmacological treatment are available. However, pharmacotherapy is generally prescribed for insomnia in primary care. Different drug classes and individual drugs are recommended by Current national and international guidelines, but the recommendations are thus inconclusive. Previous pairwise meta-analyses only compared the effect for one or two of them. And thus it is difficult to generate the clear hierarchies and superiority for the efficacy and safety of available agents.
Objectives: This network meta-analysis aims to compare different pharmacologic treatment for primary insomnia on both broad classes of drugs and individual drugs, and to provide patients, clinicians more precise decisions on the best pharmacological treatments for insomnia.
Methods: We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomised control trails focused on efficacy and safety of the agents for the treatment of primary insomnia. Using standardized study eligibility forms, teams of three reviewers independently screened all the retrieved bibliographic records according to eligibility criteria. Data extracted from included studies including general information, drug information, and outcomes of interests (adverse event, sleep onset latency, total sleep time, and wake time after sleep onset,). The methodological quality of included study was assessed using Cochrane risk of bias tool. We use R software to conduct a Bayesian framework random-effect network meta-analysis. We also rated the certainty (quality) of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Results: This study is ongoing and results will be presented at Colloquium as available.
Conclusions: This study is ongoing and results will be presented at Colloquium as available.
Patient or healthcare consumer involvement: Not Applicable