年龄对催眠药在失眠中的有效性和安全性的影响:系统性审查和元分析
Patrick Viet-Quoc Nguyen1, Thien Thanh Dang-Vu2, Philippe Leduc3
1Montreal University Hospital Centre Research Centre, 900 Rue Saint-Denis, Montreal, Quebec, H2X 0A9, Canada; Quebec Network for Research on Aging, 4565 Queen-Mary Road, Montreal, Quebec, H3W 1W5, Canada.
Sleep medicine
|November 27, 2024
概括
与年轻人相比,老年人可能会体验到催眠药对睡眠质量改善的效果较差. 进一步的研究应该详细介绍这些研究中的多病症和多药性.
科学领域:
- 老年学是指老年学的学科.
- 药理学 药理学 是一个学科.
- 睡眠医学 睡眠医学
背景情况:
- 失眠是一种普遍的睡眠障碍,影响所有年龄段的成年人.
- 催眠药通常用于慢性失眠,但它们的疗效和安全性可能因年龄不同而有所不同.
- 老年人 (≥65岁) 往往具有独特的生理特征和并发症,可能会影响治疗反应.
研究的目的:
- 系统地审查和元分析催眠药对65岁或以上人群睡眠质量的疗效和安全性,与65岁以下人群相比.
- 为了确定这些年龄组之间的催眠效果和耐受性的潜在差异.
主要方法:
- 在MEDLINE,EMBASE,Web of Science和EBM评论中对随机临床试验进行了系统的文献搜索.
- 包括在2000年1月至2022年12月期间发表的研究,比较慢性失眠的成年人的催眠药与安慰剂.
- 通过自我报告的睡眠质量问卷来评估有效性,通过可接受性和耐受性来评估安全性. 使用随机效应模型计算标准化平均差异 (SMD).
主要成果:
- 分析包括17项试验 (3688名参与者) 在≥65岁组和53项试验 (14720名参与者) 在<65岁组.
- 观察到睡眠质量改善的统计学上显著差异 (p=0.02),与年轻人群 (SMD -0.51) 相比,老年人群 (SMD -0.36) 的效果大小较小.
- 与安慰剂相比,在总人口中,催眠耐受性较差 (SMD -0.25,p<0.001),在老年人 (SMD -0.07) 与年轻人 (SMD -0.31,p=0.01) 之间报告的耐受性明显较差. 可接受性没有显著差异.
结论:
- 某些催眠类可能在改善老年人的睡眠质量方面表现出较低的有效性.
- 这些发现强调了对老年人催眠药的谨慎处方和个性化治疗方法的潜在需要.
- 未来的研究应该包含多病症和多药学的详细数据,以更好地了解不同患者群体的治疗结果.
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