Sleep problems and nocturnal arterial
oxygen desaturation are common in patients with
chronic obstructive pulmonary disease (
COPD). Hence, the safety and efficacy of new
hypnotic agents must be ascertained in this group of patients. We performed a double-blind, randomized, single-dose, placebo and active
drug controlled, crossover study in 24 patients with
insomnia (subjective sleep latency > 30 minutes and sleep duration 4-6 hours) and mild to moderate
COPD (mean FEV1 61 +/- 12(SD)% predicted) in order to establish the effects of
zolpidem 5 mg and 10 mg on sleep and respiration and to compare these effects with
triazolam 0.25 mg. Arterial oxygen saturation for the entire night, by hour and stage, and the
apnea-hypopnea index for the entire night were not significantly different with placebo and the various
drug conditions. Total sleep time and sleep efficiency were increased over placebo by all three
drug conditions.
Triazolam was more effective than
zolpidem 5 mg but not
zolpidem 10 mg, and there was no significant difference between
zolpidem 5 mg and
zolpidem 10 mg.
Zolpidem 10 mg and
triazolam both reduced the number of awakenings (> 15 seconds duration) per hour of sleep. Although there was a trend for
triazolam to be more efficacious than
zolpidem 10 mg, no statistically significant difference was found for any objective or subjective sleep variable. Likewise,
zolpidem 10 mg tended to be more efficacious than
zolpidem 5 mg, but the difference was only significant in terms of perceived sleep quality and ease of falling asleep.(ABSTRACT TRUNCATED AT 250 WORDS)