Effect of Zolpidem on Sleep Quality of Professional Firefighters; a Double Blind, Randomized, Placebo-Controlled Crossover Clinical Trial
Abstract
Professional firefighting is among the most demanding jobs. Prior studies have showed the notable prevalence of poor sleep quality among professional firefighters that may result in catastrophes. The aim of this study was in field confirmation of zolpidem usage (10 mg/PO/bed time) for short term management of poor sleeps quality among professional firefighters. In a double-blind, randomized, placebo-controlled crossover clinical trial among professional firefighters, 27 poor sleepers were assigned randomly to one of the two groups. Two 14 days experimental periods were separated by a 14-day washout phase. Sleep quality was assessed using the Persian version of Pittsburgh Sleep Quality Index (PSQI). Six of the 27 enrolled voluntaries dropped out. Two rare side effects of zolpidem occurred in the study. A significant improvement of the PSQI score was detected in zolpidem period versus placebo in both groups (7.14 ± 3.02 vs 12.38 ± 2.51, PP=0.89). Zolpidem significantly improved all components of PSQI (Subjective sleep quality, Sleep latency, Sleep duration, Habitual sleep efficiency, Sleep disturbances and Daytime dysfunction) in the current study except the use of sleep medication. Sleep onset latency was the component of PSQI with the greatest degree of abnormality among firefighters in a previous study. Interestingly, sleep latency was the component of PSQI with the most treatment effect of zolpidem in the current study. Zolpidem can be used as a part of treatment regimens in short time management of poor sleep quality among professional firefighters.
Mehrdad R, Sadeghniiat Haghighi K, et al. Sleep Quality of Professional Firefighters. IJPM 2013;4(9): 1095-100.
Carey MG, Al-Zaiti SS, Dean GE, et al. Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters. J Occup Environl Med 2011;53(8):928-33.
Lee Mh. Associated Factors Affecting Sleep Quality and Coping Strategies for Addressing Insomnia in Firefighters [Dissertation]. Instit Natural Healing Sci., 2010.
Walsleben JA, O'Malley EB, Rapoport DM. Sleep Disorders and Work. In: Rom WN, editor. Environmental and Occupational Medicine. 4th ed. New York: Lippincottm Williams & Wilkins; 2007: p. 1364-73.
Kripke DF, Langer RD, Kline LE. Hypnotics' association with mortality or cancer: a matched cohort study. BMJ Open 2012;2(1):e000850.
Holm KJ, Goa KL. Zolpidem: an update of its pharmacology, therapeutic efficacy and tolerability in the treatment of insomnia. Drugs 2000;59(4):865-89.
Terzano MG, Rossi M, Palomba V, et al. New Drugs for Insomnia. Drug Saf 2003;26(4):261-82.
Dashti-Khavidaki S, Chamani N, Khalili H, et al. Comparing effects of clonazepam and zolpidem on sleep quality of patients on maintenance hemodialysis. Iran J Kidney Dis 2011;5(6):404-9.
Van Camp RO. Zolpidem in fatigue management for surge operations of remotely piloted aircraft. Aviat Space Environ Med 2009;80(6):553-5.
Huang YS, Hsu SC, Liu SI, et al. A double-blind, randomized, comparative study to evaluate the efficacy and safety of zaleplon versus zolpidem in shortening sleep latency in primary insomnia. Chang Gung Med J 2011;34(1):50-6.
Salvà P, Costa J. Clinical pharmacokinetics and pharmacodynamics of zolpidem. Clin Pharmacokinet 1995;29(3):142-53.
Sabbatini M, Crispo A, Pisani A, et al. Zaleplon improves sleep quality in maintenance hemodialysis patients. Nephron Clin Pract 2004;94(4):c99-c103.
Fleiss JL. The design and analysis of clinical experiments. New York: JOHN WILEY & SONS; 1986.
Buysse DJ, Reynolds III CF, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193-213.
Shahidi J, Khodabakhshi R, Yahyazadeh S, et al. Quality of sleep in cancer patients: evidence from Persian translation of Pittsburg Sleep Quality Index. AJC 2007;6:165-8.
Hoque R, Chesson Jr AL. Zolpidem-induced sleepwalking, sleep related eating disorder, and sleep-driving: fluorine-
-flourodeoxyglucose positron emission tomography analysis, and a literature review of other unexpected clinical effects of zolpidem. J Clin Sleep Med 2009;5(5):471-6.
Inagaki T, Miyaoka T, Tsuji S, et al. Adverse reactions to zolpidem: case reports and a review of the literature. Prim Care Companion J Clin Psychiatry 2010;12(6):PCC.09r00849.
Maczaj M. Pharmacological treatment of insomnia. Drugs 1993;45(1):44-55.
Aronoff GM, Erdil M, Hartenbaum NP. Medications, driving and work. In: Talmage JB, Melhorn JM, editors. A physician's guide to return to work: AMA press Chicago; 2005.
Danjou P, Paty I, Fruncillo R, et al. A comparison of the residual effects of zaleplon and zolpidem following administration 5 to 2 h before awakening. Br J Clin Pharmacol 1999;48(3):367-74.
Hart CL, Ward AS, Haney M, et al. Zolpidem-related effects on performance and mood during simulated nightshift work. Exp Clin Psychopharmacol 2003;11(4):259-68.
Allain H, Patat A, Lieury A, et al. Comparative study of the effects of zopiclone (7.5 mg), zolpidem, flunitrazepam and a placebo on nocturnal cognitive performance in healthy subjects, in relation to pharmacokinetics. Eur Psychiatry 1995;10(Suppl 3):129s-35s.
Verster JC, Volkerts ER, Schreuder AH, et al. Residual effects of middle-of-the-night administration of zaleplon and zolpidem on driving ability, memory functions, and psychomotor performance. J Clin Psychopharmacol 2002;22(6):576-83.
Ito S-U, Kanbayashi T, Takemura T, et al. Acute effects of zolpidem on daytime alertness, psychomotor and physical performance. Neurosci Res 2007;59(3):309-13.
| Files | ||
| Issue | Vol 53, No 9 (2015) | |
| Section | Original Article(s) | |
| Keywords | ||
| Zolpidem Professional firefighters Sleep quality Occupational Medicine | ||
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