The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic review
Objective: We aimed to compare the efficacy and safety profiles of different dosages of dual orexin receptor antagonists (DORAs) and zolpidem on insomnia and cognitive function. Methods: Databases including PubMed, Embase, Cochrane Library, Scopus, and Google Scholar were searched for relevant artic...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Sleep Epidemiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667343623000136 |
| _version_ | 1797660240300212224 |
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| author | Mengzhen Zhou Rujia Liu Zhengqi Xie |
| author_facet | Mengzhen Zhou Rujia Liu Zhengqi Xie |
| author_sort | Mengzhen Zhou |
| collection | DOAJ |
| description | Objective: We aimed to compare the efficacy and safety profiles of different dosages of dual orexin receptor antagonists (DORAs) and zolpidem on insomnia and cognitive function. Methods: Databases including PubMed, Embase, Cochrane Library, Scopus, and Google Scholar were searched for relevant articles. The standard mean difference (SMD) was generated for consecutive variants. A dose‒response meta-regression model was constructed in RStudio 4.2.1 to compare the efficacy and safety of low, medium and high doses of DORAs and zolpidem on cognitive function and insomnia. Results: A total of 22 studies with 8,223 subjects were included. Compared with the placebo, low and medium doses of DORAs significantly decreased motor vehicle accidents/violations (SMD= -0.02, 95 % CI: -0.21 to 0.17 and SMD= -0.36, 95 % CI: -0.52 to -0.20, respectively), whereas medium and high doses of zolpidem significantly increased this index (SMD=0.77, 95 % CI: 0.39 to 1.16 and SMD=1.17, 95 % CI: 0.62 to 1.72, respectively). In addition, the total sleep time (TST) of low, medium, and high doses of DORAs was SMD=0.28, 95 % CI: - 0.15 to 0.70; SMD=1.36, 95 % CI: 0.87 to 1.86; and SMD=2.59, 95 % CI: 1.89 to 3.30, respectively. The TST of zolpidem at low, medium, and high doses was SMD=1.01, 95 % CI: 0.18 to 1.83; SMD=1.94, 95 % CI: 0.46 to 3.43; and SMD=1.71, 95 % CI: 0.86 to 2.56, respectively. Conclusion: We recommend DORAs as the best intervention for insomnia. DORAs were highly effective in inducing and maintaining sleep without impairing cognition. More head-to-head studies are needed to extend and consolidate our findings. |
| first_indexed | 2024-03-11T18:27:54Z |
| format | Article |
| id | doaj.art-64b07b296b684c7f8bce7a071f50746d |
| institution | Directory Open Access Journal |
| issn | 2667-3436 |
| language | English |
| last_indexed | 2024-03-11T18:27:54Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Sleep Epidemiology |
| spelling | doaj.art-64b07b296b684c7f8bce7a071f50746d2023-10-13T13:56:58ZengElsevierSleep Epidemiology2667-34362023-12-013100068The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic reviewMengzhen Zhou0Rujia Liu1Zhengqi Xie2Department of Neurology, Qinhuangdao First People's Hospital, Shandong First Medical University, Jinan, Shandong, China; Corresponding author.Department of Neurology, Yantai Yuhuangding Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Neurology, First Affiliated Hospital of Hebei Medical University, Tsinghua University, Shijiazhuang, Hebei, ChinaObjective: We aimed to compare the efficacy and safety profiles of different dosages of dual orexin receptor antagonists (DORAs) and zolpidem on insomnia and cognitive function. Methods: Databases including PubMed, Embase, Cochrane Library, Scopus, and Google Scholar were searched for relevant articles. The standard mean difference (SMD) was generated for consecutive variants. A dose‒response meta-regression model was constructed in RStudio 4.2.1 to compare the efficacy and safety of low, medium and high doses of DORAs and zolpidem on cognitive function and insomnia. Results: A total of 22 studies with 8,223 subjects were included. Compared with the placebo, low and medium doses of DORAs significantly decreased motor vehicle accidents/violations (SMD= -0.02, 95 % CI: -0.21 to 0.17 and SMD= -0.36, 95 % CI: -0.52 to -0.20, respectively), whereas medium and high doses of zolpidem significantly increased this index (SMD=0.77, 95 % CI: 0.39 to 1.16 and SMD=1.17, 95 % CI: 0.62 to 1.72, respectively). In addition, the total sleep time (TST) of low, medium, and high doses of DORAs was SMD=0.28, 95 % CI: - 0.15 to 0.70; SMD=1.36, 95 % CI: 0.87 to 1.86; and SMD=2.59, 95 % CI: 1.89 to 3.30, respectively. The TST of zolpidem at low, medium, and high doses was SMD=1.01, 95 % CI: 0.18 to 1.83; SMD=1.94, 95 % CI: 0.46 to 3.43; and SMD=1.71, 95 % CI: 0.86 to 2.56, respectively. Conclusion: We recommend DORAs as the best intervention for insomnia. DORAs were highly effective in inducing and maintaining sleep without impairing cognition. More head-to-head studies are needed to extend and consolidate our findings.http://www.sciencedirect.com/science/article/pii/S2667343623000136DORAZolpidemCognitionInsomnia, Meta-analysis |
| spellingShingle | Mengzhen Zhou Rujia Liu Zhengqi Xie The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic review Sleep Epidemiology DORA Zolpidem Cognition Insomnia, Meta-analysis |
| title | The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic review |
| title_full | The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic review |
| title_fullStr | The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic review |
| title_full_unstemmed | The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic review |
| title_short | The effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function: A meta-analysis and systematic review |
| title_sort | effects of different dosages of dual orexin receptor antagonists and zolpidem on sleep and cognitive function a meta analysis and systematic review |
| topic | DORA Zolpidem Cognition Insomnia, Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2667343623000136 |
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