Long-Term, Non-Nightly Administration of Zolpidem in the Treatment of Patients With Primary Insomnia
Abstract
Introduction While it is common practice that hypnotics are used on a non-nightly basis, few investigations have been undertaken to evaluate the efficacy of the intermittent dosing strategy. The present study was designed to further evaluate this issue within a large scale, double-blind, placebo-controlled, long-term trial. Method Patients who met DSM-IV criteria for primary insomnia participated in the study from January 2000 through October 2001. Patients were randomly assigned to 1 of 2 treatment groups (zolpidem 10 mg or placebo) for a period of 12 weeks. Ten pills were provided in foil packs on an every-other-week basis, and patients were instructed to take no fewer than 3 and no more than 5 pills per week. Sleep was evaluated daily with sleep diaries. Pill use was recorded in the sleep diaries. Results 199 patients (mean +/- SD age = 41.0 +/- 12.8 years; 71% female) were randomly assigned to treatment. On mean, patients receiving zolpidem exhibited (vs. baseline) a 42% decrease in sleep latency, a 52% reduction in number of awakenings, a 55% decrease in wake time after sleep onset, and a 27% increase in total sleep time. These positive clinical gains did not diminish with time and were not associated with dose escalation. There was also no evidence of rebound insomnia. Conclusions Over a period of 12 weeks of intermittent treatment with zolpidem, sleep continuity was significantly improved, the clinical gains were sustained, and there was no evidence of subjective rebou…
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Empirical data support both nightly and intermittent (2-5 times per week) administration of hypnotics.
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- Authors
- Perlis, M. L., McCall, W. V., Krystal, A. D., & Walsh, J. K.
- Affiliations
- University of Rochester Medicine (US)
- Wake Forest University (US)
- Duke University (US)
- Saint Louis University (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2004-08-15
- Volume
- 65
- Issue
- 8
- Pages
- 1128-1137
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1995438590
- Cited by
- 144
- References
- 0
- Citations by year
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- FWCI
- 18.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- zolpidem, primary insomnia, intermittent dosing, hypnotics, long-term treatment, sleep latency, awakening, wake after sleep onset, total sleep time, rebound insomnia, dose escalation, sleep continuity
- MeSH terms
- Zolpidem, Adolescent, Adult, Double-Blind Method, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Longitudinal Studies, Male, Medical Records, Middle Aged, Placebos, Pyridines, Surveys and Questionnaires, Sleep, Treatment Outcome
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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