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It is not clear as to whether the new nonbenzodiazepine hypnotics ( Z-drugs ) are better than the short-acting benzodiazepines.
The efficacy of these two groups of medications is similar.
According to the US Agency for Healthcare Research and Quality, indirect comparison indicates that side-effects from benzodiazepines may be about twice as frequent as from nonbenzodiazepines.
This may make the non-benzodiazepines preferable as the first-line long-term treatment of insomnia.
However, the UK National Institute for Health and Clinical Excellence did not find any convincing evidence in favor of Z-drugs.
NICE review pointed out that short-acting Z-drugs were inappropriately compared in clinical trials with long-acting benzodiazepines.
There have been no trials comparing short-acting Z-drugs with appropriate doses of short-acting benzodiazepines.
Based on this, NICE recommended choosing the hypnotic based on cost and the patient's preference.

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