title: Magic bullets for insomnia? Patients' use and experiences of newer (Z drugs) versus older (benzodiazepine) hypnotics for sleep problems in primary care.
abstract: BACKGROUND
  Little is known about patients' perceptions of newer hypnotics.
  
  
  OBJECTIVE
  To investigate use, experience, and perceptions of Z drug and benzodiazepine hypnotics in the community.
  
  
  METHODS
  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.
  
  
  METHODS
  Lincolnshire, UK.
  
  
  METHODS
  Self-administered postal questionnaire.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Health, Life and Social Sciences, University of Lincoln, Brayford Pool, Lincoln. nsiriwardena@lincoln.ac.uk
authors.forename: A Niroshan
authors.initials: AN
authors.lastname: Siriwardena
authors.forename: M Zubair
authors.initials: MZ
authors.lastname: Qureshi
authors.forename: Jane V
authors.initials: JV
authors.lastname: Dyas
authors.forename: Hugh
authors.initials: H
authors.lastname: Middleton
authors.forename: Roderick
authors.initials: R
authors.lastname: Orner
mesh_terms: D000081:Acetamides / Q000008:administration & dosage / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D053961:Azabicyclo Compounds / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000209:etiology*; D000077334:Zolpidem
chemical_list: D000081:Acetamides; D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; D011725:Pyridines; D011743:Pyrimidines; C515050:zopiclone; D001569:Benzodiazepines; D000077334:Zolpidem; C085665:zaleplon