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Titolo:
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
Autore:
Saletu-Zyhlarz, G; Anderer, P; Brandstatter, N; Dantendorfer, K; Gruber, G; Mandl, M; Ritter, K; Zoghlami, A; Saletu, B;
Indirizzi:
Univ Vienna, Sch Med, Dept Psychiat, A-1090 Vienna, Austria Univ Vienna Vienna Austria A-1090 Dept Psychiat, A-1090 Vienna, Austria
Titolo Testata:
NEUROPSYCHOBIOLOGY
fascicolo: 3, volume: 41, anno: 2000,
pagine: 139 - 148
SICI:
0302-282X(2000)41:3<139:PSLSOT>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
GENERALIZED ANXIETY DISORDER; DAYTIME VIGILANCE; PHARMACO-EEG; FLUNITRAZEPAM; DISTURBANCES; EPIDEMIOLOGY; DEPRESSION; TRIAZOLAM; ALPIDEM;
Keywords:
zolpidem; sleep quality; nonorganic insomnia; anxiety disorders; polysomnography; psychometry;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
64
Recensione:
Indirizzi per estratti:
Indirizzo: Saletu, B Univ Vienna, Sch Med, Dept Psychiat, Wahringer Gurtel 18-20, A-1090 Vienna, Austria Univ Vienna Wahringer Gurtel 18-20 Vienna Austria A-1090 ustria
Citazione:
G. Saletu-Zyhlarz et al., "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", NEUROPSYCHB, 41(3), 2000, pp. 139-148

Abstract

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-relateddisorders (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, zolpidemincreased the length of S4 and 53 + 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, asa 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 andawakening 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 different from those after classical benzodiazepines, Copyright (C) 2000 S. Karger AG, Basel.

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Documento generato il 07/08/20 alle ore 06:28:31