Efficacy of zolpidem in insomnia

Priest, R. G.; Terzano, Mario G.; Parrino, Liborio; Boyer, Pascal

doi:10.1016/s0924-9338(97)80015-6

Cited by 14 publications

(5 citation statements)

References 19 publications

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“…Reviewing 12 short-term, 7 medium-term and 5 longterm studies regarding the subjective assessment of the hypnotic efficacy of zolpidem by means of questionnaires or clinical global assessment scales as well as 10 placebocontrolled studies on objective measures of hypnotic activity involving the use of polysomnography, Priest et al [55] concluded that the hypnotic efficacy of zolpidem had repeatedly been demonstrated in polysomnographic studies, with subjective assessments confirming these results. However, as these patients were generally referred to as chronic insomniacs, psychiatric inpatients, insomniac outpatients or elderly insomniacs, it remains open which specific sleep disorder -as for instance defined in the ICSD or DSM-IV -would benefit most from zolpidem.…”

Section: Discussionmentioning

confidence: 99%

Placebo-Controlled Sleep Laboratory Studies on the Acute Effects of Zolpidem on Objective and Subjective Sleep and Awakening Quality in Nonorganic Insomnia Related to Neurotic and Stress-Related Disorder

Saletu-Zyhlarz

Anderer²,

Brandstätter³

et al. 2000

Neuropsychobiology

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Recent investigations in our sleep outpatient clinic demonstrated that 30% of patients exhibited organic and 70% nonorganic sleep disorders, with 41% showing as an additional diagnosis neurotic, stress-related, and somatoform disorders, 31% affective disorders and 15% mental and behavioral disorders due to psychoactive substance use. Thus, the aim of the study was to investigate the acute effects of the imidazopyridine zolpidem on objective and subjective sleep and awakening quality in the largest of the above-mentioned groups. In this single-blind, placebo-controlled cross-over study, 15 patients (9 females and 6 males aged 51.1 + 11.3 years) diagnosed as having nonorganic insomnia (ICD–10: F 51.0) related to neurotic and stress-related disorders (F 1.1:12, F 41.2:2 and F 43.2:1) were included. Objective and subjective sleep and awakening quality measures were investigated in 3 subsequent nights in the sleep laboratory (adaptation, baseline/placebo and zolpidem 10 mg night), utilizing clinical, polysomnographic, psychometric and psychophysiological methods. The drug-free patients were matched according to age and sex with 15 normal healthy controls (age 51.2 + 11.8 years). Statistical analysis of polysomnographic variables demonstrated a significant lengthening of the total sleep period (TSP) and total sleep time (TST), an improvement in sleep efficiency and a shortening of sleep latencies after zolpidem as compared with placebo. These changes were opposite to the differences between patients and controls. Concerning sleep architecture, zolpidem increased the length of S4 and S3 + S4 as compared with placebo. Subjective sleep and awakening quality and the thymopsychic variables drive, mood, affectivity and wakefulness in the morning showed no significant changes, as a significant improvement had already occurred from the adaptation to the baseline/placebo night. Noopsychic variables (attention, concentration, attention variability, numerical memory, fine motor activity, reaction time measures) showed similar findings. Moreover, subjective sleep and awakening quality, thymopsychic and noopsychic measures during baseline/placebo recordings did not differ significantly from normative data (except for fine motor activity). Psychophysiological measures did not show any significant alterations either, except for a decrease in systolic blood pressure in the evening. Conclusion: As compared with placebo, zolpidem induced a significant improvement in objective sleep quality, mainly by increasing TSP, TST and sleep efficiency and shortening sleep latencies, thereby normalizing the disorder of initiating and maintaining sleep. Deep sleep stages S3 + S4 increased (although at baseline/placebo these stages did not differ from controls), while S1, S2 and SREM did not change significantly. Subjective sleep and awakening quality as well as thymopsychic and noopsychic performance in the morning mainly showed a placebo and ‘first- night effect’ phenomenon in these patients. Thus, the changes induced by zolpidem were somewhat diff...

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Section: Discussionmentioning

confidence: 99%

Placebo-Controlled Sleep Laboratory Studies on the Acute Effects of Zolpidem on Objective and Subjective Sleep and Awakening Quality in Nonorganic Insomnia Related to Neurotic and Stress-Related Disorder

Saletu-Zyhlarz

Anderer²,

Brandstätter³

et al. 2000

Neuropsychobiology

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“…The hypnotic activity of zolpidem has also been explored in different patient populations and assessment included both objective and subjective measures of hypnotic efficacy for different treatment durations, with results confirming that 10 mg is superior to placebo [32]. Consequently, 10 mg is the recommended dose for the short‐term treatment of insomnia in the nonelderly; in elderly patients 5 mg has been shown to be effective at inducing sleep while giving an optimum safety profile [33].…”

Section: Zolpidemmentioning

confidence: 99%

Role of Zolpidem in the Management of Insomnia

Dang

Garg

Rataboli

2011

CNS Neuroscience & Therapeutics

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Insomnia is a common condition that affects one's ability to sleep comfortably and consequently to work effectively. Its etiology is multifactorial and involves plethora of risk factors. Consequences can vary from mild sleepiness to more sever psychiatric disturbances and ischemic stroke. Despite several diagnostic criteria it is poorly diagnosed and less often treated. Benzodiazepines formed the mainline therapy for many years till the advent of newer nonbenzodiazepine group of drugs including zolpidem. Zolpidem is an imidazo-pyridine compound that enhances the GABA(A) receptor function by interaction with Omega-1 receptor subtype. Its pharmacokinetic profile allows the patients to use it later in the night when having trouble falling asleep without any residual cognitive impairment the next morning. It has rapid onset of action, improves total sleep duration, and reduces night-time awakenings. Its adverse effect profile is satisfactory as it appears to have low addiction potential. This review will focus on the current role of zolpidem in the management of insomnia.

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“…A large number of clinical studies of the efficacy of zolpidem in inducing and maintaining sleep, involving tens of thousands of patients, have been carried out and the results have been published. Several detailed reviews of this literature are available (44,59,95). Zolpidem's activity has been evaluated using subjective assessments in which patients responded to questionnaires concerning the latency, quality, and duration of their sleep.…”

Section: Clinical Experience With Zolpidem Efficacymentioning

confidence: 99%