Objective To evaluate the effectiveness and safety of ramelteon for chronic insomnia in adults. Methods The following databases as CENTRAL, PubMed, EMbase, ISI, CNKI, CBMdisc, VIP and WanFang Data were searched from the date of their establishment to November 2010. The randomized controlled trials (RCTs) meeting the inclusion criteria were included. The data extraction and quality assessment were conducted according to the methods of Cochrane Reviewers’ Handbook recommend by The Cochrane Collaboration, and meta-analysis was performed with RevMan5.0 software. Results A total of 5 RCTs involving 1 772 patients were included. The results of meta-analyses showed that: a) Effectiveness: In the effectiveness, ramelteon was superior to placebo in latency to persistent sleep (MD=18.36, 95%CI 11.55 to 25.18, Plt;0.000 01), total sleep time (MD= –15.47, 95%CI –22.50 to –8.43, Plt;0.000 1), sleep efficiency (MD= –3.39, 95%CI –5.32 to –1.46, P=0.000 6), sleep quality (MD=0.14, 95%CI 0.03 to 0.25, P=0.01) after one week treatment and latency to persistent sleep (MD=13.02, 95%CI 6.01 to 20.03, P=0.000 3) except for wake after sleep onset (MD= –8.79, 95%CI –17.24 to –0.35, P=0.04) after one month treatment. b) Safety: significant differences were only found in the female prolactin (MD=5.50, 95%CI 2.02 to 8.98, P=0.002) and male free testosterone (MD=15.30, 95%CI 0.62 to 29.98, P=0.04) between the two groups, rather than in all the other hormones concentration, rebound insomnia, withdrawal syndrome, next-day residual effects and incidence rate of adverse reactions. Conclusion Ramelteon has marked effects on adults’ chronic insomnia after 1-week treatment, but its effect is not obvious after 1-month treatment. The adverse reactions are mostly the somnolence, rising of male free testosterone and female prolactin concentration.
ObjectiveTo investigate the chronic insomnia incidence and traditional Chinese medical (TCM) constitution of students in Southern Medical University, in order to discover the correlation between chronic insomnia and TCM constitution. MethodsA survey by means of the TCM Constitution Scales, the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the Deep Sleep Scale (DSS) in 110 participants studying in Southern Medical University between September 2009 and July 2014 was conducted. We analyzed the characteristics of chronic insomnia in subjects of qi-deficiency type and gentleness type. ResultsA total of 115 questionnaires were sent out, and 110 were recovered with a recovery rate of 95.65%. All the 110 questionnaires were useful and the effective rate was 100%. There were 34 cases of gentleness type and 44 cases of qi-deficiency type in the 110 participants. It was found that qideficiency type got significantly different scores for all the three types of scales, compared with gentleness type (P＜ 0.01) . Meanwhile, qi-deficiency type showed significant differences in terms of sleep quality, sleep time, sleep disorder and daytime dysfunction from gentleness type (P＜ 0.05) . We also found that the incidences of shallow sleep and insomnia for qi-deficiency type were higher than those for gentleness type (P=0.002, 0006) , respectively. Finally, it was detected that the level of insomnia for qi-deficiency type was higher than that for gentheness type (P＜ 0.01) . Conclusions This study has revealed that there is a statistically significant association between qi-deficiency type and chronic insomnia. It is suggested that further research should be conducted for cure of chronic insomnia from the perspective of changing TCM constitution.