SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science III. Sleep Disorders – Insomnia
0519
TWELVE MONTHS OF NIGHTLY ZOLPIDEM DOES
NOT PRODUCE WITHDRAWAL SYMPTOMS ON DRUG
DISCONTINUATION: A PROSPECTIVE PLACEBO
CONTROLLED STUDY
Roehrs T 1,2 , Randall S 1 , Harris E 1 , Maan R 1 , Roth T 1,2
1
Sleep Disorders & Research Center, Henry Ford Health System,
Detroit, MI, USA, 2 Psychiatry & Behavioral Neuroscience, Wayne
State University School of Medicine, Detroit, MI, USA
Introduction: Animal studies have demonstrated physical dependence
with benzodiazepine receptor agonists (BzRAs). In patients chronic use
of therapeutic doses of BzRA anxiolytics is associated with withdrawal,
but reports of withdrawal with BZRA hypnotics are less conclusive. This
study prospectively tested for withdrawal symptoms after 12 months of
nightly use of the BzRA hypnotic, zolpidem 10mg.
Methods: 29 DSM-IVR defined primary insomniacs, ages 32-64 yrs,
with a sleep efficiency (sleep time/bed time) of 20 is considered clinically significant).
The number of severe symptom ratings (2) given for any one of the
20 symptoms was 3/15 in the placebo group and 1/14 in the zolpidem
group. Placebo and zolpidem groups did not differ in their ratings on any
of the 20 symptoms individually.
Conclusion: In insomniacs, zolpidem 10 mg was not associated with
withdrawal after chronic nightly administration, suggesting with hypnotics,
a condition in which receptors are unoccupied for 16 hours a
day, there is no withdrawal. This contrasts with BzRA anxiolytics, where
receptors are occupied all day, and withdrawal is reported.
Support (If Any): NIDA, grant#: R01DA17355 awarded to Dr. Roehrs.
0520
THE EFFICACY OF COGNITIVE BEHAVIORAL THERAPY
FOR INSOMNIA ON FATIGUE SYMPTOM
Yang C 1,2 , Lin Y 1 , Yang T 3
1
Department of Psychology, National Chengchi University, Taipei,
Taiwan, 2 The Research Center for Mind, Brain, and Learning, National
Chengchi University, Taipei, Taiwan, 3 School of Medicine, Fu-Jen
University, Taipei, Taiwan
Introduction: Fatigue is one of the most common daytime complaints
in patients with insomnia. Cognitive behavioral therapy for insomnia
(CBT-I) has been proved to decrease fatigue in patients with insomnia
comorbid with cancer. However, it is still not clear if CBT-I is effective
in decreasing fatigue among patients with primary insomnia. The
goals of this study are to: 1) investigate the effect of CBT-I on fatigue
complaint, and 2) explore the association between the improvement in
fatigue and changes in sleep-related psychological factors, including
sleep beliefs, sleep habits, and arousal symptoms in patient with primary
insomnia.
Methods: 67 patients with primary insomnia were recruited for the
study. Before and after a 6-week CBT-I program, they completed a
package of questionnaires including situational fatigue scale (SFS), dysfunctional
beliefs and attitudes about sleep scale (DBAS), sleep hygiene
practice scale (SHPS), pre-sleep arousal scale (PSAS), insomnia severity
index (ISI).
Results: Prior to the CBT-I, physical fatigue (PF) and mental fatigue
(MF) correlated significantly with ISI. PF decreased significantly following
CBT-I (F=7.33, p < .01), while MF did not (F=1.13, n.s.). The
decrease of PF correlated significantly with the decrease of score on
Cognitive Arousal subscale of PSAS (r=0.24, p