Effects of Repeated Administration of Zolpidem on Sleep, Diurnal and Nocturnal Respiratory Function, Vigilance, and Physical Performance in Patients with COPD

To assess the effects of repeated 10-mg oral doses of zolpidem on diurnal and nocturnal respiratory function, as well as on diurnal vigilance and physical performance in COPD patients with disordered sleep. Prospective single-blind placebo-controlled clinical study. Outpatients of a respiratory medicine department. Patients with stable COPD were enrolled for 10 days (D0 to D10), ie, 9 consecutive nights (N1 to N9). They received placebo on N1 and N9 and zolpidem, 10 mg, from N2 to N8. The following parameters were measured: nocturnal polysomnographic recordings with respiratory signals and arterial blood gas values on retiring and awakening on NO, N1, N2, N8, and N9; subjective evaluation of the quality of sleep and of diurnal vigilance by visual analog scales every day from DO to D10; pulmonary function test, central control of breathing, and walking test on DO and D9; biological laboratory tests and theophylline level on DO and D8. Ten COPD patients (PaO2=72.7±7.6 mm Hg; PaCO2=47.7±5.4 mm Hg; FEV1=0.84±0.3 L; FEV1/vital capacity=42.5±12.3%), 56.8±8.3 years old, were studied. Compared with placebo, no significant change was found for the various sleep architecture parameters, except an increase in the duration of stage 2 during the D8/N8 night (p