Treatment Effects of Gabapentin for Primary Insomnia

Lo, Hsiao-Sui; Yang, Chien‐Ming; Lo, Helen G.; Lee, Chien‐Ying; Ting, Hua; Tzang, Bor‐Show

doi:10.1097/wnf.0b013e3181cda242

Cited by 104 publications

(61 citation statements)

References 39 publications

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“…36 Gabapentin's positive effects on sleep maintenance were accompanied by less stage 1 sleep and greater slow wave sleep (relative to placebo). This is in agreement with other published reports where the effects of gabapentin on sleep architecture are selective, in that stage 1 is preferentially reduced and slow wave sleep increased, 19,[21][22][23][24][25]27,36 although other findings have been reported (e.g., increase in REM sleep). 24,25 A decrease in light sleep (stage 1) with a parallel increase in deeper sleep (stages 3-4) suggests a deepening or consolidation of sleep, which may play a key role in sleep's restorative processes.…”

Section: Discussionsupporting

confidence: 93%

“…The beneficial sleep maintenance effects of gabapentin in this study are consistent with findings from another phase advance study that examined gabapentin 250 mg following single and multiple day dosing, 36 and a small open-label trial of gabapentin (mean dose 540 mg/day for 4 weeks) in participants with complaints of difficulty initiating and/or maintaining sleep for at least 3 months. 27 Like the present results, neither of these studies demonstrated an effect on sleep latency.…”

Section: Discussioncontrasting

confidence: 67%

“…[19][20][21][22][23][24][25][26] One small, open-label study in otherwise healthy individuals with complaints of difficulty initiating and/or maintaining sleep for more than 3 months showed that, compared with baseline, gabapentin increased sleep efficiency, decreased wake after sleep onset (WASO), and increased slow wave sleep, but did not affect sleep onset latency. 27 Although these studies suggest that gabapentin has favorable effects on sleep, the applicability of these findings to individuals who have occasional difficulty sleeping can be addressed via large, double-blind, placebo-controlled studies evaluating various doses of gabapentin in individuals with occasional sleep difficulties in a validated model of transient sleep disturbance. The primary objective of this study was to examine the dose-dependent (250 and 500 mg) efficacy of gabapentin, using both PSG and participant-reported assessments of sleep in participants with a history of occasional disturbed sleep.…”

mentioning

confidence: 99%

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A Randomized, Double-Blind, Single-Dose, Placebo-Controlled, Multicenter, Polysomnographic Study of Gabapentin in Transient Insomnia Induced by Sleep Phase Advance

Rosenberg

Hull

Lankford

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives:To evaluate the effects of single doses of gabapentin 250 and 500 mg on polysomnographic (PSG) and participant-reported sleep measures in a 5-h phase advance insomnia model. Methods: Adults reporting occasional disturbed sleep received gabapentin 500 mg (n = 125), 250 mg (n = 125), or placebo (n = 127) 30 min prior to bedtime and were in bed from 17:00 to 01:00, ~5 h before their habitual bedtime. Sleep was assessed by PSG, post-sleep questionnaire, and the Karolinska Sleep Diary (KSD greater and percent stage 1 (15.1%, 11.8%, and 10.8%, respectively) signifi cantly lower relative to placebo. Gabapentin was associated with signifi cantly higher values of KSD Sleep Quality Index and reported TST versus placebo; no other reported outcomes were signifi cant. Neither gabapentin dose produced evidence of next-day residual effects as measured by DSST and SSS. Adverse events were infrequent (< 5%). Conclusion: Participants with occasional disturbed sleep treated with gabapentin showed signifi cantly longer sleep duration and greater depth (versus placebo) in response to a phase advance manipulation known to disrupt sleep maintenance.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 67%

mentioning

confidence: 99%

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A Randomized, Double-Blind, Single-Dose, Placebo-Controlled, Multicenter, Polysomnographic Study of Gabapentin in Transient Insomnia Induced by Sleep Phase Advance

Rosenberg

Hull

Lankford

et al. 2014

Journal of Clinical Sleep Medicine

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“…Insomnia severity of patients across studies was not able to be compared as one study provided scores for the insomnia severity index (39), two for the Athens insomnia scale (41,42) and two for the Pittsburgh sleep quality index (known to measure sleep quality, not insomnia symptoms) (40,43). …”

Section: Demographics and Data Inclusionmentioning

confidence: 99%

Heart rate variability in insomnia patients: A critical review of the literature

Dodds

Miller

Kyle

et al. 2017

Sleep Medicine Reviews

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SummaryHeart rate variability (HRV) is an objective marker that provides insight into autonomic nervous system dynamics. There is conflicting evidence regarding the presence of HRV impairment in insomnia patients. Web-based databases were used to systematically search the literature for all studies that compared the HRV of insomnia patients to controls or reported the HRV of insomnia patients before and after an intervention. 22 relevant papers were identified. Study characteristics were summarised, HRV measures were extracted and a risk of bias assessment for each study was performed. We were limited in our ability to synthesise outcome measures and perform metaanalyses due to considerable differences in patient (and control) selection, study protocols, measurement and processing techniques and outcome reporting. Risk of bias was deemed to be high in the majority of studies. As such, we cannot confirm that HRV is reliably impaired in insomnia patients nor determine the HRV response to interventions. Whilst HRV impairment in insomnia is a widely accepted concept, it is not supported by empirical evidence. Large longitudinal studies incorporating 24-hour recordings are required to elucidate the precise nature of HRV dynamics in insomnia patients. Key Wordsautonomic nervous system, heart rate variability, hyperarousal, insomnia, review HEART RATE VARIABILITY IN INSOMNIA PATIENTS

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“…In addition, gabapentin's positive effects on nighttime awakenings reported in these 3 cases may have been due to its known general sleep-enhancing actions 9 and not to a specific effect on the nighttime awakenings theorized here to have been caused by low serum estradiol and coined LUNAs.…”

Section: Casementioning

confidence: 73%

Nighttime Awakenings Responding to Gabapentin Therapy in Late Premenopausal Women: A Case Series

Guttuso

2012

Journal of Clinical Sleep Medicine

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Insomnia related to nighttime awakenings is known to be more prevalent in women than men. Three cases are presented here of late premenopausal women experiencing frequent nighttime awakenings that responded well to bedtime treatment with gabapentin. In one case, what started as isolated nighttime awakenings slowly progressed to awakenings accompanied by typical menopausal night sweats. This led to the theory that the initial isolated nighttime awakenings in this patient may have been secondary to a menopausal etiology related to low serum estradiol levels. In the subsequent 2 cases, early follicular phase serum estradiol was confi rmed to be low. It is theorized that isolated nighttime awakenings in some premenopausal women may be caused by low serum estradiol, triggering events physiologically related to menopausal night sweats. Further research is needed to determine if low early follicular phase serum estradiol is associated with nighttime awakenings in premenopausal women not experiencing night sweats.

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Treatment Effects of Gabapentin for Primary Insomnia

Abstract: Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.

Cited by 104 publications

References 39 publications

A Randomized, Double-Blind, Single-Dose, Placebo-Controlled, Multicenter, Polysomnographic Study of Gabapentin in Transient Insomnia Induced by Sleep Phase Advance

A Randomized, Double-Blind, Single-Dose, Placebo-Controlled, Multicenter, Polysomnographic Study of Gabapentin in Transient Insomnia Induced by Sleep Phase Advance

Heart rate variability in insomnia patients: A critical review of the literature

Nighttime Awakenings Responding to Gabapentin Therapy in Late Premenopausal Women: A Case Series

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