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Magic bullets for insomnia? Patients’ use and experience of newer (z drugs) versus older (benzodiazepine) hypnotics for sleep problems in primary care

By Aloysius Niroshan Siriwardena, Mohammed Zubair Qureshi, Jane Dyas, Hugh Middleton and Roderick Orner

Abstract

Background Little is known about patients' perceptions of newer hypnotics.\ud Aim\ud To investigate use, experience, and perceptions of Z drug and benzodiazepine hypnotics in the community.\ud Design of study\ud Cross-sectional survey of general practice patients who had received at least one prescription for a Z drug or benzodiazepine in the previous 6 months.\ud Setting\ud Lincolnshire, UK.\ud Method\ud Self-administered postal questionnaire.\ud Results\ud Of 1600 surveys posted, 935 (58.4%) responses were received, of which 705 (75.4%) were from patients taking drugs for insomnia. Of those 705 patients, 87.9% (n = 620) were first prescribed a hypnotic by their GP, and 94.9% (n = 669) had taken a sleeping tablet for 4 weeks or more. At least one side effect was reported in 41.8% (n = 295); 18.6% wished to come off hypnotic medication; and 48.5% had tried to stop treatment. Patients on Z drugs were more likely to express a wish to stop (22.7% versus 12.3%; odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.13 to 2.49), or to have attempted to come off medication, than those on benzodiazepines (52.4% versus 41.0%; OR = 1.54, 95% CI = 1.12 to 2.12). The two groups did not differ significantly in respect of benefits or adverse effects.\ud Conclusion\ud There were no significant differences in patients' perceptions of efficacy or side-effects reported by those on Z drugs compared to patients taking benzodiazepines. Side-effects were commonly reported, which may have contributed to a high proportion of responders, particularly patients on Z drugs who were wishing to stop, or who had previously tried to stop taking this medication. Reported prescribing practices were often at variance with the licence for short-term use

Topics: A300 Clinical Medicine
Publisher: Royal College of General Practitioners
Year: 2008
DOI identifier: 10.3399/bjgp08X299290
OAI identifier: oai:eprints.lincoln.ac.uk:2058
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