• A Niroshan Siriwardena, M Zubair Qureshi, Jane V Dyas, Hugh Middleton, and Roderick Orner.
• Faculty of Health, Life and Social Sciences, University of Lincoln, Brayford Pool, Lincoln. nsiriwardena@lincoln.ac.uk
• Br J Gen Pract. 2008 Jun 1; 58 (551): 417422417-22.

BackgroundLittle is known about patients' perceptions of newer hypnotics.AimTo investigate use, experience, and perceptions of Z drug and benzodiazepine hypnotics in the community.Design Of StudyCross-sectional survey of general practice patients who had received at least one prescription for a Z drug or benzodiazepine in the previous 6 months.SettingLincolnshire, UK.MethodSelf-administered postal questionnaire.ResultsOf 1600 surveys posted, 935 (58.4%) responses were received, of which 705 (75.4%) were from patients taking drugs for insomnia. Of those 705 patients, 87.9% (n = 620) were first prescribed a hypnotic by their GP, and 94.9% (n = 669) had taken a sleeping tablet for 4 weeks or more. At least one side effect was reported in 41.8% (n = 295); 18.6% wished to come off hypnotic medication; and 48.5% had tried to stop treatment. Patients on Z drugs were more likely to express a wish to stop (22.7% versus 12.3%; odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.13 to 2.49), or to have attempted to come off medication, than those on benzodiazepines (52.4% versus 41.0%; OR = 1.54, 95% CI = 1.12 to 2.12). The two groups did not differ significantly in respect of benefits or adverse effects.ConclusionThere were no significant differences in patients' perceptions of efficacy or side-effects reported by those on Z drugs compared to patients taking benzodiazepines. Side-effects were commonly reported, which may have contributed to a high proportion of responders, particularly patients on Z drugs who were wishing to stop, or who had previously tried to stop taking this medication. Reported prescribing practices were often at variance with the licence for short-term use.

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