Comparative effectiveness and safety of pharmacological interventions for sleep outcomes in chronic non-cancer pain: a systematic review and network meta-analysis.
Jeremy R Chang, Yuyang Zhang, Yilan Zhang et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated the effectiveness and safety of pharmacological interventions for sleep outcomes in individuals with chronic non-cancer pain, analyzing 98 RCTs with 28,920 participants. Melatonin was found to significantly improve sleep quality compared to placebo (SMD = -0.60), while other agents showed improvements but with lower-certainty evidence and higher risks of adverse events.
Key findings
- Melatonin significantly improved sleep quality compared to placebo (SMD = -0.60).
- Ten pharmacological agents showed significant improvements in sleep quality (SMD = -0.24 to -1.07).
- Most pharmacological agents were associated with an increased risk of adverse events (OR = 1.90 to 37.00).
- Melatonin was not associated with an increased risk of adverse events (OR = 0.88).
Why it matters
Understanding the effectiveness and safety of pharmacological treatments for sleep disturbances in chronic pain patients is crucial, as these issues can exacerbate pain severity and negatively impact overall prognosis.
What to keep in mind
The study's findings are limited by the high proportion of trials at high risk of bias and the predominance of subjective sleep outcomes.