NICE points out that: €Although hypnotics can provide relief from the symptoms of insomnia, they do not treat any underlying cause.€19 Its key therapeutic topic [KTT6] on hypnotics states: €The risks associated with hypnotics (including melatonin) such as falls, cognitive impairment, dependence and withdrawal symptoms, are well recognised. Hypnotics should be used only if insomnia is severe, using the lowest dose that controls symptoms for short periods of time.€

In addition, practitioners should €review and, if appropriate, optimise prescribing of hypnotics to ensure that it is in line with national guidance.€

NICE's technology appraisal guidance (TA77) from 2004 on zaleplon, zolpidem and zopiclone for the short-term management of insomnia emphasises the need to limit use of hypnotics, and use only if considered necessary.19

In addition: €It is recommended that, because of the lack of compelling evidence to distinguish between zaleplon, zolpidem, zopiclone or the shorter-acting benzodiazepine hypnotics, the drug with the lowest purchase cost (taking into account daily required dose and product price per dose) should be prescribed.€