Effects of after-midnight intake of zolpidem and temazepam on driving ability in women with non-organic insomnia

Partinen, Markku; Hirvonen, Kari; Hublin, Christer; Halavaara, Mika; Hiltunen, H

doi:10.1016/j.sleep.2003.06.005

Cited by 49 publications

(39 citation statements)

References 23 publications

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“…The STISIM drive simulator, used in similar investigations (Lenne et al, 2003;Partinen et al, 2003), has been tested recently across the multiple sleep latency test, the current neurophysiological standard for assessing daytime sleepiness, and its reliability in repeated measurements has been proved Pizza et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Effects of prolonged wakefulness combined with alcohol and hands-free cell phone divided attention tasks on simulated driving

Iudice

Bonanni

Gelli

et al. 2005

Hum. Psychopharmacol. Clin. Exp.

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Simulated driving ability was assessed following administration of alcohol, at an estimated blood level of 0.05%, and combined prolonged wakefulness, while participants were undertaking divided attention tasks over a hands-free mobile phone. Divided attention tasks were structured to provide a sustained cognitive workload to the subjects. Twenty three young healthy individuals drove 10 km simulated driving under four conditions in a counterbalanced, within-subject design: alcohol, alcohol and 19 h wakefulness, alcohol and 24 h wakefulness, and while sober. Study measures were: simulated driving, self-reported sleepiness, critical flicker fusion threshold (CFFT), Stroop word-colour interference test (Stroop) and simple visual reaction times (SVRT). As expected, subjective sleepiness was highly correlated with both sleep restriction and alcohol consumption. The combination of alcohol and 24 h sustained wakefulness produced the highest driving impairment, significantly beyond the alcohol effect itself. Concurrent alcohol and 19 h wakefulness significantly affected only driving time-to-collision. No significant changes of study measures occurred following alcohol intake in unrestricted sleep conditions. CFFT, SVRT and Stroop results showed a similar trend in the four study conditions. Thus apparently 'safe' blood alcohol levels in combination with prolonged wakefulness resulted in significant driving impairments. In normal sleep conditions alcohol effects on driving were partially counteracted by the concomitant hands-free phone based psychometric tasks.

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Section: Discussionmentioning

confidence: 99%

Effects of prolonged wakefulness combined with alcohol and hands-free cell phone divided attention tasks on simulated driving

Iudice

Bonanni

Gelli

et al. 2005

Hum. Psychopharmacol. Clin. Exp.

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show abstract

“…Then, the subjects underwent a standardized simulated road driving session: the simulation was performed with the STISIM Driving Simulator (System Technology Inc., USA). The STISIM drive is a low-cost, personal computer-based, interactive driving simulator, largely used in similar studies (Risser et al, 2000;Iudice et al, 2002;Partinen et al, 2003;Iudice et al, 2005). Subjects were administered a preliminary 5-min training session, after which they were left alone in a silent room to execute the test.…”

Section: Methodsmentioning

confidence: 99%

Effects of Alzheimer's disease and mild cognitive impairment on driving ability: a controlled clinical study by simulated driving test

Frittelli

Borghetti

Iudice

et al. 2008

Int J Geriat Psychiatry

135

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“…[21][22][23] Profound impairment of driving ability is present 4 hours after ingestion of both 10 and 20 mg doses, and lasts perhaps as long as 6 hours. [24][25][26][27] However, most studies of the effect of zolpidem on driving have examined the next day residual effect and have shown no impairment when conducted eight or nine hours after ingestion. 28,29 The reason that zolpidem is often implicated in sleep-related complex behaviors is not clear, but it is the most often prescribed sleeping pill in the United States.…”

Section: Legal Case 4 April 2009mentioning

confidence: 99%

Zolpidem Ingestion, Automatisms, and Sleep Driving: A Clinical and Legal Case Series

Poceta

2011

Journal of Clinical Sleep Medicine

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study Objectives: To describe zolpidem-associated complex behaviors, including both daytime automatisms and sleeprelated parasomnias. Methods: A case series of eight clinical patients and six legal defendants is presented. Patients presented to the author after an episode of confusion, amnesia, or somnambulism. Legal defendants were being prosecuted for driving under the infl uence, and the author reviewed the cases as expert witness for the defense. Potential predisposing factors including comorbidities, social situation, physician instruction, concomitant medications, and patterns of medication management were considered. Results: Patients and defendants exhibited abnormal behavior characterized by poor motor control and confusion. Although remaining apparently interactive with the environment, all reported amnesia for 3 to 5 hours. In some cases, the episodes began during daytime wakefulness because of accidental or purposeful ingestion of the zolpidem and are considered automatisms. Other cases began after ingestion of zolpidem at the time of going to bed and are considered parasomnias. Risk factors for both wake and sleep-related automatic complex behaviors include the concomitant ingestion of other sedating drugs, a higher dose of zolpidem, a history of parasomnia, ingestion at times other than bedtime or when sleep is unlikely, poor management of pill bottles, and living alone. In addition, similar size and shape of two medications contributed to accidental ingestion in at least one case. Conclusions s C i e n T i F i C i n V e s T i g a T i O n sT he ingestion of zolpidem and other hypnotic sedative medications for the treatment of insomnia has been associated with sleepwalking and other complex behaviors including sleep eating and sleep driving.1-5 When ingested during the daytime, hypnotic sedatives impair cognition, memory, and motor performance. 6 There are also reports of a high frequency of blood levels of hypnotic sedatives in drivers apprehended for driving under the infl uence (DUI).7-9 An advisory letter was sent and change in package insert information occurred on March 14, 2007, alerting physicians and the public to the possibility of complex behaviors with all hypnotic sedatives.According to the prescribing information for Ambien and Ambien CR, zolpidem is an imidazopyridine chemical class agent available in the US since 1992. It is chemically unrelated to benzodiazepine and barbiturate hypnotic sedatives. Zolpidem in vitro binds the BZ1 receptor of the GABA(A) complex with high affi nity ratio for the alpha1/alpha5 subunits. Mean peak concentrations were 59 (range 29 to 113) after ingestion of the 5 mg tablet and 121 (range 58 to 272) after ingestion of the 10 mg tablet (ng/mL). Time to maximum concentration was 1.6 h for both doses (but 2.2 h if taken with food) with a half-life of approximately 2.6 h (range 1.4 to 4.5) The zolpidem extended release formulation 12.5 mg tablets produced a maximum concentration of 134 (69 to 197) at 1.5 hours. Co-administration with fl uoxetine increased ha...

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Effects of after-midnight intake of zolpidem and temazepam on driving ability in women with non-organic insomnia

Cited by 49 publications

References 23 publications

Effects of prolonged wakefulness combined with alcohol and hands-free cell phone divided attention tasks on simulated driving

Effects of prolonged wakefulness combined with alcohol and hands-free cell phone divided attention tasks on simulated driving

Effects of Alzheimer's disease and mild cognitive impairment on driving ability: a controlled clinical study by simulated driving test

Zolpidem Ingestion, Automatisms, and Sleep Driving: A Clinical and Legal Case Series

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