Study: Lower Dose of Insomnia Medication More Effective
For Americans who depend on sleeping pills to aid their chronic insomnia—defined as difficulty staying asleep at least 3 nights weekly for at least 1 month or difficulty falling asleep—switching to a dosing strategy that utilizes half of the drugs and placebos could be more effective than standard prescribing practices, according to a recent study.
“The clinical effects of sleeping pills cannot be relied on to last forever, and long-term use increases risk of psychological dependence and side effects including daytime drowsiness, nausea, and muscle pain,” said Michael Perlis, PhD, the study’s senior author, an associate professor in Penn’s department of Psychiatry and director of the Penn Behavioral Sleep Medicine Program.
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“Our research found that changing the industry standard for maintenance therapy can maintain treatment responses and lower the incidence of side effects,” he said.
For the study, investigators placed 74 adults who experienced chronic insomnia on 10 mg per night of zolpidem (Ambien dosing regimen) for a 4-week duration.
Patients who responded well to the dosing regimen were then assigned to 1 of 3 treatment groups for an additional 12 weeks: Group 1 was administered 10 mg or 5 mg per night, while the second group was allowed 10 mg for 2 to 4 times a week, and the final group was assigned a 10 mg nightly regimen (50% of the pills were placebos and have were the active drug).
While all 3 regiments allowed participants to fall asleep and stay asleep, researchers observed that the group assigned to 10 mg for 2 to 4 times per week reported more frequent and severe side effects, as well as sleeping poorer, than the other 2 groups.
“Our findings also go against the standard practice of ‘start low and go slow,’ in favor of a ‘start high and go low’ dosing strategy in which a patient starts with 10 mg nightly and then when the desired result is reached, switch to either a lower nightly dose or intermittent dosing with placebos on non-medication nights,” commented Peril.
Moving forward, participants may be able to influence the prescription for maintenance therapy including what drug is used, what dose is prescribed, and what time of day to take the medication.
The complete study is published in the August issue of Sleep Medicine.
-Michelle Canales Butcher
Reference:
Penn Medicine. Penn study shows chronic insomnia sufferers may find relief with half of standard sleeping pill dosing regimen. August 3, 2015. www.uphs.upenn.edu/news/News_Releases/2015/08/perlis/. Accessed August 6, 2015.