Clin Mol Hepatol.  2019 Jun;25(2):199-209. 10.3350/cmh.2018.0084.

Effects of zolpidem on sleep parameters in patients with cirrhosis and sleep disturbances: A randomized, placebo-controlled trial

• Sharma MK
• Kainth S
• Kumar S
• Bhardwaj A
• Agarwal HK
• Maiwall R
• Jamwal KD
• Shasthry S
• Jindal A
• Choudhary
• Anand L
• Dhamija RM
• Kumar G
• Sharma BC
• Sarin SK

• KMID: 2451924
• DOI: http://doi.org/10.3350/cmh.2018.0084

Abstract

BACKGROUND/AIMS
The aim of this study was to study the efficacy and safety of zolpidem for sleep disturbances in patients with cirrhosis.
METHODS
Fifty-two Child-Turcotte-Pugh (CTP) class A or B cirrhotics with Pittsburgh Sleep Quality Index >5 were randomized to either zolpidem 5 mg daily (n=26) or placebo (n=26) for 4 weeks.
RESULTS
The therapy of 4 weeks was completed by 23 patients receiving zolpidem (3 stopped treatment due to excessive daytime drowsiness) and 24 receiving placebo (2 refused to continue the study). In the zolpidem group, after 4 weeks of therapy, there was significant increase in total sleep time (TST) and sleep efficiency compared to baseline and improvement in polysomnographic parameters of sleep initiation and maintenance (i.e., decrease in sleep latency time, decrease in wake time, and decreases in number of arousals and periodic limbs movements per hour of sleep), without any significant change in sleep architecture.
CONCLUSIONS
Four weeks of 5 mg daily zolpidem in CTP class A or B cirrhosis patients with insomnia led to significant increases in TST and sleep efficiency and improvement in polysomnographic parameters of sleep initiation and maintenance without any significant change in sleep architecture.

Keyword

Cirrhosis; Sleep; Zolpidem; Insomnia

MeSH Terms

Arousal
Cytidine Triphosphate
Extremities
Fibrosis*
Humans
Sleep Initiation and Maintenance Disorders
Cytidine Triphosphate