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Clonazepam for the management of sleep disorders

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Abstract

Background

The objectives of this review and meta-analysis of polysomnographic data are those to focus on the clinical use of clonazepam for the management of sleep disorders by re-analyzing clinical trials and randomized clinical trials which have been published in peer-reviewed journals.

Methods

A review of the literature including clinical trials and randomized controlled trials was performed in PubMed®, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. A random effects model meta-analysis was then carried out for the four more frequently reported polysomnographic measures: total sleep time, sleep latency, sleep efficiency, and periodic leg movement during sleep (PLMS) index.

Results

A total of 33 articles were retrieved and screened in full text, of which 18 met the criteria for review; among the latter, nine met the criteria for meta-analysis. The studies included in the review involved patients with insomnia, REM sleep behavior disorder, sleep bruxism, and restless leg syndrome or PLMS which reported, most often, an increase in total sleep time with clonazepam. A clear sleep-promoting effect of clonazepam was found also by meta-analysis.

Discussion and conclusions

Our results indicate that the pharmacological treatment of sleep disorders with clonazepam must always be personalized according to the type of patient, the risk of addiction and the concomitant presence of respiratory disorders are key factors to take into account. However, in light of the clinical evidence of the few studies in the literature on the different types of disorders, more studies on the use of clonazepam (also in association with first choice treatments) are definitely needed.

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Funding

Funding for this study was provided by the Italian Ministry of Health Grant RC n. 2773803; the Italian Ministry of Health had no further role in study design, in the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the paper for publication.

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Authors and Affiliations

  1. Unit of Neurology, G.B. Morgagni – L. Pierantoni Civic Hospital, 34 Via Carlo Forlanini, 47121, Forlì, Italy

    Alberto Raggi

  2. Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy

    Maria Paola Mogavero

  3. Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy

    Maria Paola Mogavero

  4. Seattle Children’s Hospital and University of Washington, Seattle, WA, USA

    Lourdes M. DelRosso

  5. Sleep Research Centre, Oasi Research Institute – IRCCS, Troina, Italy

    Raffaele Ferri

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  1. Alberto Raggi
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  2. Maria Paola Mogavero
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  3. Lourdes M. DelRosso
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  4. Raffaele Ferri
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Correspondence to Alberto Raggi.

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Raggi, A., Mogavero, M.P., DelRosso, L.M. et al. Clonazepam for the management of sleep disorders. Neurol Sci 44, 115–128 (2023). https://doi.org/10.1007/s10072-022-06397-x

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