Lo Hsiao-Sui, Yang Chien-Ming, Lo Helen G, Lee Chien-Ying, Ting Hua, Tzang Bor-Show
Department of Neurology and Sleep Center, Chung Shan Medical University and University Hospital, Tai-Chung, Taiwan.
Clin Neuropharmacol. 2010 Mar-Apr;33(2):84-90. doi: 10.1097/WNF.0b013e3181cda242.
The prevalence of insomnia is very high in our society. Although pharmacological treatment of insomnia is available, most hypnotics have been shown to alter sleep architecture and have many adverse effects. Gabapentin was originally designed for antiepileptic therapy; however, some studies reported that its use increases slow-wave sleep in healthy volunteers or patients. Our goal was to evaluate the benefits of gabapentin in the treatment of primary insomnia in patients.
Eighteen patients with primary insomnia participated in the study. They received gabapentin treatment for at least 4 weeks. All patients received polysomnography, a biochemical blood test, and neuropsychological tests before and after the treatment period. All measures were analyzed with Student t test to examine the treatment effects of gabapentin, except that the measures of heart rate variability were analyzed with analysis of variance.
Polysomnographic study revealed increased sleep efficiency and slow-wave sleep, decreased wake after sleep onset, and spontaneous arousal index after gabapentin treatment. The biochemical blood test revealed decreased prolactin levels in the morning after treatment. Electroencephalographic power spectral analysis showed increased delta-2 and theta power in sleep stage 1 and decreased sigma activity power in sleep stages N2 and N3 after gabapentin treatment. Heart rate variability analyses also showed a significant increase in normalized high frequency percentage in sleep stages N2 and N3 and low frequency-high frequency ratio in sleep stage N2 after treatment. In addition, neuropsychological tests revealed the elevation of visual motor processing speed after gabapentin treatment.
Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.
在我们的社会中，失眠的患病率非常高。尽管有针对失眠的药物治疗，但大多数催眠药已被证明会改变睡眠结构并具有许多不良反应。加巴喷丁最初是为抗癫痫治疗而设计的；然而，一些研究报告称，其使用可增加健康志愿者或患者的慢波睡眠。我们的目标是评估加巴喷丁在治疗患者原发性失眠中的益处。
18名原发性失眠患者参与了该研究。他们接受了至少4周的加巴喷丁治疗。所有患者在治疗期前后均接受了多导睡眠图检查、血液生化检测和神经心理学测试。除心率变异性指标采用方差分析外，所有测量指标均采用学生t检验来检验加巴喷丁的治疗效果。
多导睡眠图研究显示，加巴喷丁治疗后睡眠效率提高、慢波睡眠增加、睡眠起始后觉醒减少以及自发觉醒指数降低。血液生化检测显示治疗后早晨催乳素水平降低。脑电图功率谱分析显示，加巴喷丁治疗后睡眠第1阶段的δ-2和θ功率增加，而睡眠第N2和N3阶段的σ活动功率降低。心率变异性分析还显示，治疗后睡眠第N2和N3阶段的标准化高频百分比显著增加，睡眠第N2阶段的低频-高频比值增加。此外，神经心理学测试显示加巴喷丁治疗后视觉运动处理速度提高。
加巴喷丁可增强原发性失眠患者的慢波睡眠。它还通过提高睡眠效率和减少自发觉醒来改善睡眠质量。结果表明，加巴喷丁可能对原发性失眠的治疗有益。
