Deprescribing benzodiazepine receptor agonists taken for insomnia: a review and key messages from practice guidelines

Abstract

Long‑term benzodiazepine receptor agonist (BZRA) use for insomnia is common and highly prevalent in adults in all care settings. Evidence syntheses suggest that the therapeutic benefits of benzodiazepines for insomnia are marginal and very short term. On the harm side, BZRAs are associated with daytime sedation and confusion. Long‑term use increases the risk of falls, fractures, cognitive impairment, and motor vehicle accidents. An evidence‑based clinical practice guideline has been developed to assist with deprescribing BZRAs. This review highlights the rationale for deprescribing BZRAs used for insomnia and summarizes key messages for clinicians from the new BZRA deprescribing guideline and their supporting evidence.