Long-Term Treatment of Insomnia with Zolpidem: A Multicentre General Practitioner Study of 107 Patients

Abstract

The effects of zolpidem, an imidazopyridine derivative, were studied in 107 patients suffering from insomnia, 60.9% of whom were over 60 years of age, in a 6-month, single-blind, flexible dose, general practitioner study. Comparison was made between baseline, last day of treatment and 10 days after the end of treatment to assess efficacy and rebound insomnia. An improvement in all efficacy parameters--time taken to fall asleep, total amount of nocturnal sleep and number of nocturnal awakenings--was reported by the investigator and the patients; the improvement was evident from the first evaluation day and was maintained throughout the trial. Improvement was also maintained during the washout period with a lack of rebound insomnia. There was no sign of withdrawal symptoms and tolerance to zolpidem did not develop over the 6-month treatment period. Adverse events were mild and infrequent, and tended to resolve with a dose reduction. It is concluded that 10 mg/day zolpidem is an appropriate starting dose and is effective and safe for the treatment of sleep disturbances of different origins.

Relationship of Zolpidem and Cancer Risk: A Taiwanese Population-Based Cohort Study

“…A single-blind trial published in 1991 reported on the nightly use of zolpidem for up to 6 months; the authors concluded that 10 mg/d is an appropriate starting dose and is effective and safe for the treatment of sleep disturbances of various origins. 5 Generally, because of zolpideminduced amnesia for sleep disturbances, this popular drug is thought to produce a patient's subjectively better quality of sleep without the evident adverse effects that usually accompany hypnotics. The risk of abuse and tolerance is low when zolpidem is used as directed.…”

Cognitive Behavioral Therapy in the Treatment of Insomnia

“…Similar comparisons and the volume of adequately reported data necessary for pooling limited the amount of analysis that could be conducted with these data. CBT-I = cognitive behavioral therapy for insomnia; CI = confidence interval; ISI = Insomnia Severity Index; k = number of studies; MD = mean difference; NR = not reported; NS = no statistical difference between groups; PSQI = Pittsburgh Sleep Quality Index; RR = risk ratio; SC = stimulus control; SMD = standardized mean difference; SOE = strength of evidence; WMD = weighted mean difference (113). Low Insufficient Insufficient Insufficient Insufficient AIS = Athens Insomnia Scale; BBT = brief behavioral therapy; CBT-I = cognitive behavioral therapy for insomnia; CI = confidence interval; ISI = Insomnia Severity Index; k = number of studies; MBT = multicomponent behavioral therapies; MD = mean difference; NR = not reported; NS = no statistical difference between groups; PSQI = Pittsburgh Sleep Quality Index; SC = stimulus control; SMD = standardized mean difference; SOE = strength of evidence; WMD = weighted mean difference CBT-I = cognitive behavioral therapy for insomnia; CI = confidence interval; ISI = Insomnia Severity Index; k = number of studies; NR = not reported; SMD = standardized mean difference; SOE = strength of evidence; WMD = weighted mean difference…”

“…60,[111][112][113][114][115] Treatment duration was between 4 and 6 weeks for five of the trials. One trial was longer-term, with treatment duration up to 8 months.…”

“…Participants were overwhelmingly white. Five trials were conducted in the United States 60,[112][113][114][115] and one in Europe and Canada. 111 Four trials evaluated a 10 mg dose 60,111,112,115 and two trials evaluated 10 and 15 mg doses.…”

“…111 Four trials evaluated a 10 mg dose 60,111,112,115 and two trials evaluated 10 and 15 mg doses. 113,114 One trial administered a 5 mg dose for participants 60 years of age or older. 115 Risk of bias was moderate in all trials.…”