You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Zopiclone as night medication in rheumatoid arthritis.
Abstract 1:
Sleep disturbances and related daytime complaints are frequent in rheumatoid arthritis ( RA ) . The aim of the current study was therefore to evaluate the effect of a newer hypnotic on sleep structure and clinical parameters in RA . Forty out patients were r and omized to a two week treatment regimen with either 7.5 mg zopiclone or placebo at bedtime . Clinical examinations were performed before and after treatment and the degree of pain , fatigue , sleepiness , morning stiffness , and activities of daily living were assessed . Two sleep question naires were also completed weekly .  Polysomnography  was performed before the study and after 14 days of treatment . Recordings were evaluated using conventional sleep scoring as well as frequency analysis of the  electroencephalography ( EEG ) . Patients in the zopiclone group had subjective improvement of sleep , but otherwise no differences in pain score or the other clinical parameters were found . Conventional sleep assessment s showed only minor changes during treatment , but frequency analysis demonstrated a shift from the lower towards the higher EEG frequencies in the active treatment group . Although the modulation of the EEG can represent a non-specific pharmacologic epiphenomenon , it might also reflect a disturbance of sleep microstructure . In conclusion , treatment with zopiclone may be of value for subjective sleep complaints in selected patients with RA , but it is doubtful whether hypnotics improve daytime symptoms in this patient group


Title 2:
Night medication in rheumatoid arthritis.
Abstract 2:
The efficacy of indomethacin 100 mg , diazepam 10 mg , and placebo in producing sleep , relieving night pain , and reducing the severity of morning stiffness , was compared in 18 patients in hospital with active classical or definite rheumatoid arthritis . There was no statistically significant difference in the preference of patients or sleep score among the three forms of treatment . Both indomethacin and diazepam were more effective than placebo in relieving night pain .  Indomethacin decreased , but diazepam increased , morning stiffness in comparison to placebo . Neither active therapy produced significant side-effects


Title 3:
Night medication in rheumatoid arthritis. III. the use of sulindac.
Abstract 3:
A double-blind controlled trial was carried out in 18 in- patients with classical or definite rheumatoid arthritis to assess the effectiveness of night-time medication with 100 mg indomethacin plus 10 mg diazepam , 200 mg sulindac , and 200 mg sulindac plus 10 mg diazepam in improving sleep and reducing night pain and the duration of morning stiffness . Patients received each treatment regimen for 1 night . The results from the 17 patients completing the full trial protocol indicated that indomethacin plus diazepam was the most effective of the three regimens , although the differences did not reach conventional statistical significance . It is suggested that in further such studies with sulindac a larger dose and a longer duration of treatment should be used


Title 4:
Night medication in rheumatoid arthritis: II. Combined therapy with indomethacin and diazepam.
Abstract 4:
Seventeen of eighteen patients hospitalized for active rheumatoid arthritis completed a three-day r and omized , double-blind comparison of 100 mg indomethacin , 100 mg indomethacin with 10 mg diazepam and matching placebo as night medication . The results showed a consistent pattern in the four functions measured -- pain , morning stiffness , sleep score and patient preference . In each , indomethacin proved superior to placebo and the combined therapy better than indomethacin alone . From this it has been concluded that the combination of indomethacin and diazepam should now be considered the treatment of choice for maximum control of night pain and morning stiffness in rheumatoid arthritis


Title 5:
Effects of triazolam on sleep, daytime sleepiness, and morning stiffness in patients with rheumatoid arthritis.
Abstract 5:
OBJECTIVE To evaluate the effects of triazolam upon insomnia and daytime sleepiness in patients with rheumatoid arthritis ( RA ) . METHODS Triazolam or placebo was administered during two 7 night periods to 15 patients with RA in a double blind crossover study .  Polysomnographic recordings  were conducted on the last 2 nights of each condition , and  multiple sleep latency tests and mood and arthritis assessment s were performed during the intervening day in each condition . RESULTS In the triazolam condition , total sleep time was increased , daytime sleepiness was reduced , and morning stiffness was improved compared to placebo . Objective measures of sleep fragmentation were unchanged . Clinical arthritis assessment s were similar during both conditions . CONCLUSION Short term hypnotic therapy improves sleep in patients with RA and appears to improve morning stiffness and daytime sleepiness
Overall , the included trials failed to find evidence of a beneficial effect of muscle relaxants over placebo ( at 24 hours , 1 week , or 2 weeks ) or in addition to nonsteroidal antiiflammatory drugs ( at 24 hours ) on pain intensity , function , or quality of life .
Based upon the currently available evidence in patients with IA , benzodiazepines ( diazepam and triazolam ) do not appear to be beneficial in improving pain over 24 hours or 1 week .
The non-benzodiazepine agent zopiclone also did not significantly reduce pain over 2 weeks .
However , even short-term muscle relaxant use ( 24 hours to 2 weeks ) is associated with significant adverse events , predominantly drowsiness and dizziness