Pharmacological intervention for insomnia and other sleeping related disorders in palliative care patients: systematic review

Background:

Insomnia and sleep disturbances are highly prevalent in palliative care patients and are associated with reduced quality of life, increased symptom burden, and psychological distress. Despite the frequent prescription of pharmacological sleep interventions in this vulnerable population, evidence regarding their efficacy and safety remains limited.

Aim:

To systematically evaluate the efficacy and safety of pharmacological interventions for insomnia and related sleep disorders in adult palliative care patients.

Methods:

We are conducting a Cochrane systematic review and meta-analysis of randomized controlled trials investigating pharmacological treatments for insomnia in adults with advanced, incurable diseases. Interventions include benzodiazepines, Z-substances, melatonin, antidepressants, antipsychotics, and other sleep-promoting agents. Primary outcomes include patient-reported sleep quality, sleep duration, sleep latency, daytime functioning, and adverse events. Secondary outcomes include quality of life, anxiety, and other symptom-related outcomes.

Results:

The review is currently ongoing.

Conclusion:

This project aims to provide a comprehensive evidence synthesis on pharmacological treatment of insomnia in palliative care. The findings will support evidence-based clinical decision-making, identify gaps in current research, and inform future guideline development for symptom management in patients with serious illness.