MINIMAL REBOUND INSOMNIA AFTER TREATMENT WITH 10-MG ZOLPIDEM

This study examined rebound insomnia after discontinuation of chronic use of zolpidem (10 mg), a short elimination half-life imidazopyridine . The zolpidem group was bracketed by a placebo,stoup and a positive c ontrol group taking 0.5 mg of triazolam (twice the recommended dose), which is known to produce rebound insomnia. Ninety-nine patients with sleep complaints that were polysomnographically documented participate d in the study. After randomization, patients completed a 2-night, sin gle-blind, placebo baseline period, a 28-night double-blind treatment phase, and a 3-night, single-blind, placebo substitution period. Polys omnographic and subjective sleep variables indicated a lack of rebound insomnia for the zolpidem group. The positive triazolam control group had rebound insomnia only on the first discontinuation night. There w as no significant correlation between rebound insomnia and the level o f initial insomnia, the degree of response to treatment in week 4, or the amount of tolerance that developed during drug use. During the 4-w eek treatment period, efficacy diminished for both drugs. From these d ata, it cannot be determined whether the lack of rebound insomnia with zolpidem is a result of drug dose or some property of the drug such a s receptor selectivity.