Clonidine is better than zopiclone for insomnia treatment in chronic pain patients.

Abstract

STUDY OBJECTIVES:

Chronic pain is associated with insomnia. The objective of this clinical study was to compare the efficacy and safety of different prescribed doses of zopiclone and clonidine for the management of insomnia in patients with chronic pain.

METHODS:

This prospective observational crossover study included 160 consenting adult patients receiving pain management treatment. For insomnia treatment, each patient ingested different prescribed doses of zopiclone or clonidine on alternate nights. Each patient used a special validated sleep diary to collect data including pain score, sleep scores, sleep duration, sleep medication dose, and adverse effects. Each patient completed the diary for 3 continuous weeks. Pain was measured using a numeric pain rating scale. Sleep score was measured using the Likert Sleep Scale. A change in the pain or sleep scores by 2 points was considered significant. Of the 160 study participants, 150 (93.8%) completed the study successfully, and their data were analyzed with IBM SPSS Statistics 25 (IBM Corporation, Armonk, NY) using Student's t test, analysis of variance, Pearson chi-square test, and regression analysis. A P value < .05 was considered significant.

RESULTS:

Pain score was lower with clonidine than zopiclone (P = .025). Time to fall asleep was shorter with clonidine than zopiclone (P = .001). Feeling rested on waking in the morning was better with clonidine than zopiclone (P = .015). Overall sleep quality was better with clonidine than zopiclone (P = .015). Total Likert sleep score was better with clonidine than zopiclone (P = .005). Total sleep duration was better with clonidine than zopiclone (P = .013). Adverse effects were commoner with zopiclone, including collapse, fall, confusion, amnesia, mood disorder, hallucination, nightmare, nocturnal restlessness, locomotor dysfunction, nausea and headache. A minor adverse effect of dry mouth was commoner with clonidine.

CONCLUSIONS:

Clonidine is significantly better than zopiclone with respect to sleep quality, analgesia, tolerability profile, and patient safety. Further studies comparing clonidine with other insomnia medications will be beneficial.

CITATION:

Bamgbade OA, Tai-Osagbemi J, Bamgbade DO, et al. Clonidine is better than zopiclone for insomnia treatment in chronic pain patients. J Clin Sleep Med. 2022;18(6):1565-1571.

• Authors: Olumuyiwa A Bamgbade, Jemima Tai-Osagbemi, Daniel O Bamgbade, Ofeoritse Murphy-Akpieyi, Abisola Fadire, Nikki K Soni, Lise Mumporeze
• Journal: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (J Clin Sleep Med) Vol. 18 Issue 6 Pg. 1565-1571 (06 01 2022) ISSN: 1550-9397 [Electronic] United States
• PMID: 35112665 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2022 American Academy of Sleep Medicine.

Chemical References

• Azabicyclo Compounds
• Hypnotics and Sedatives
• Piperazines
• zopiclone
• Clonidine

Topics

• Adult
• Azabicyclo Compounds
• Chronic Pain (complications, drug therapy)
• Clonidine (therapeutic use)
• Cross-Over Studies
• Humans
• Hypnotics and Sedatives (therapeutic use)
• Piperazines
• Sleep Initiation and Maintenance Disorders (complications, drug therapy)