Table_1_Physicians’ attitudes toward hypnotics for insomnia: A questionnaire-based study.DOCX

IntroductionBenzodiazepines and non-benzodiazepines are still widely prescribed despite safety concerns and the introduction of novel hypnotics (orexin receptor antagonists [ORA] and melatonin receptor agonists [MRA]), which may be influenced by physicians’ attitudes toward hypnotics.MethodsA questionnaire survey was administered to 962 physicians between October 2021 and February 2022, investigating frequently prescribed hypnotics and the reasons for their selection.ResultsORA were the most frequently prescribed at 84.3%, followed by non-benzodiazepines (75.4%), MRA (57.1%), and benzodiazepines (54.3%). Compared to non-frequent prescribers of hypnotics, a logistic regression analysis showed that frequent ORA prescribers were more concerned with efficacy (odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.01–2.54, p = 0.044) and safety (OR: 4.52, 95% CI: 2.99–6.84, p < 0.001), frequent MRA prescribers were more concerned with safety (OR: 2.48, 95% CI: 1.77–3.46, p < 0.001), frequent non-benzodiazepine prescribers were more concerned with efficacy (OR: 4.19, 95% CI: 2.91–6.04, p < 0.001), and frequent benzodiazepine prescribers were more concerned with efficacy (OR: 4.19, 95% CI: 2.91–6.04, p < 0.001) but less concerned with safety (OR: 0.25, 95% CI: 0.16–0.39, p < 0.001).DiscussionThis study suggested that physicians believed ORA to be an effective and safe hypnotic and were compelled to prescribe benzodiazepine and non-benzodiazepine frequently, choosing efficacy over safety.

尽管存在安全顾虑以及新型催眠药物的引入（如促食欲素受体拮抗剂[ORA]和褪黑素受体激动剂[MRA]），苯二氮䓬类药物和非苯二氮䓬类药物的处方仍然广泛存在。这种状况可能受到医师对催眠药物态度的影响。
方法：于2021年10月至2022年2月期间对962名医师进行了问卷调查，旨在探讨常见催眠药物的处方情况及其选择原因。
结果：ORA的处方频率最高，达到84.3%，其次是非苯二氮䓬类药物（75.4%）、MRA（57.1%）和苯二氮䓬类药物（54.3%）。与不常处方催眠药物的医师相比，逻辑回归分析显示，常处方ORA的医师对疗效（优势比[OR]：1.60，95%置信区间[CI]：1.01–2.54，p = 0.044）和安全性的关注更高（OR：4.52，95% CI：2.99–6.84，p < 0.001）；常处方MRA的医师对安全性的关注更高（OR：2.48，95% CI：1.77–3.46，p < 0.001）；常处方非苯二氮䓬类药物的医师对疗效的关注更高（OR：4.19，95% CI：2.91–6.04，p < 0.001）；而常处方苯二氮䓬类药物的医师对疗效的关注同样较高（OR：4.19，95% CI：2.91–6.04，p < 0.001），但对安全性的关注则相对较低（OR：0.25，95% CI：0.16–0.39，p < 0.001）。
讨论：本研究表明，医师认为ORA是一种有效且安全的催眠药物，并且出于对苯二氮䓬类药物和非苯二氮䓬类药物频繁处方的需要，他们更倾向于选择疗效而非安全性。