Sleep Med Psychophysiol.  2019 Dec;26(2):86-103. 10.14401/KASMED.2019.26.2.86.

Development of Safety Usage Guidelines for Sedative Hypnotics Using the Delphi Technique

  • 1Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea.
  • 2Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.
  • 3Korea University Chronobiology Institute, Seoul, Korea.


The objective of this study was to develop evidence- and consensus-based clinical safety usage guidelines for sedative hypnotics using the Delphi technique.
A group of 15 sleep experts from Korean Academy of Sleep Medicine were chosen for this study comprising a three-round web-based Delphi survey. The first round survey was composed of 39 questions to identify problems with sedative hypnotics usage in Korean clinical practice and the result roughly outlined what should be included in the guidelines. The second round survey was composed of 21 questions to collect specific opinions of experts on clinically important issues in prescribing sedative hypnotics, and its result provided the basis for the guidelines. A third round survey aimed to evaluate the reliability and validity of the established guidelines.
In the third round, all 17 items showed a median of 4 or more, with an average of 4.12 and a standard deviation of 0.32. Thus we present safety usage guidelines with 13 propositions for prescription, maintenance, and withdrawal of sedative hypnotics.
The safety usage guidelines on sedative hypnotics developed from this study could lead to safe and effective prescription of hypnotics in clinical practice, especially for the non-experts in sleep medicine. Furthermore, the guidelines will help to improve the quality of insomnia treatment by contributing to the establishment of a safe regime for sedative hypnotics without excessive use of drugs.


Benzodiazepine; Guideline; Hypnotics; Safety; Sedatives; Zolpidem

MeSH Terms

Delphi Technique*
Hypnotics and Sedatives*
Reproducibility of Results
Sleep Initiation and Maintenance Disorders
Hypnotics and Sedatives
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