Effect of zolpidem on sleep in women with perimenopausal and postmenopausal insomnia: A 4-week, randomized, multicenter, double-blind, placebo-controlled study

Background: Although most adults in the United States obtain less sleep than they need, women report more sleep deprivation throughout their lifetime than do men. The prevalence of self-reported sleep difficulty increases as women make the transition from the premenopausal to the postmenopausal period. Objective: The purpose of this study was to assess the clinical efficacy and safety of zolpidem as a treatment for insomnia in perimenopausal and postmenopausal women. Methods: Women who were perimenopausal or postmenopausal for greater than or equal to6 months, who had developed insomnia in conjunction with menopausal symptoms, and who had difficulty maintaining sleep or had nonrestorative sleep for greater than or equal to6 months were eligible for this 4-week, multicenter study Sleep maintenance difficulty had to occur an average of greater than or equal to3 nights per week and had to be accompanied by greater than or equal to2 nocturnal hot flashes, hot flushes, or night sweats. Patients were randomized in a double-blind fashion to 1 of 2 treatment groups-zolpidem 10 mg or placebo. Capsules were provided in weekly blister cards, and patients were instructed to take 1 capsule each night at bedtime. Patients recorded estimates of their sleep quality and quantity and daytime functioning on daily morning and evening questionnaires, and made weekly global assessments of sleep. Results: The study included 141 women (mean age +/- SD, 50.8 +/- 4.5 years; age range, 39-60 years). increases in reported total sleep time were significantly greater in the zolpidem group than in the placebo group (P < 0.01) for each treatment week. Wake time after sleep onset and number of awakenings decreased significantly in the zolpidem group compared with the placebo group (P < 0.05). Each week, approximately twice as many patients in the zolpidem group as in the placebo group reported improved sleep (P < 0.001 for each week). The improvement in sleep-related difficulty with daytime functioning was significantly greater in the zolpidem group than in the placebo group (P < 0.05). The effects of zolpidem did not diminish with the duration of treatment. Conclusions: Zolpidem 10 mg/d was effective and well tolerated in the treatment of menopause-related insomnia in perimenopausal and postmenopausal women. (Clin Ther 2004-126-.1578-1586) Copyright (C) 2004 Excerpta Medica, Inc.