Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, Virginia USA.
Nat Sci Sleep. 2010 Aug 4;2:151-8. doi: 10.2147/nss.s5133. Print 2010.
Insomnia is a common sleep complaint in the elderly. The safety and efficacy of eszopiclone, a non-benzodiazepine hypnotic, in elderly patients with chronic insomnia has been established in two 2-week and one 12-week randomized, double-blind, placebo-controlled trials. Eszopiclone 1 mg was effective in reducing sleep latency. Eszopiclone 2 mg was effective in reducing latency to sleep and for increasing sleep maintenance. Eszopiclone doses of 1 mg and 2 mg reduced the number of daytime naps and decreased the duration of naps in elderly patients. Eszopiclone 2 mg improved the quality of life measures for mood, physical health, household activities, medication, leisure activities, and self-report of physical functioning and vitality in the 2-week trials, and vitality and general health in the 12-week trial. The most commonly reported side effects in the elderly included unpleasant taste, dry mouth, dizziness, and somnolence. The concurrent use of drugs that inhibit or induce the cytochrome P450 enzyme CYP3A4 can alter concentrations of eszopiclone and the dose may need to be adjusted. The recommended starting dose of eszopiclone for difficulty falling asleep is 1 mg at bedtime. For elders who complain of difficulty maintaining sleep, eszopiclone should be initiated at 2 mg at bedtime. Overall, eszopiclone is a safe and well-tolerated treatment option for elderly patients with insomnia.
失眠是老年人常见的睡眠问题。在两项为期 2 周和一项为期 12 周的随机、双盲、安慰剂对照试验中，已证实非苯二氮䓬类催眠药佐匹克隆在慢性失眠的老年患者中的安全性和疗效。佐匹克隆 1mg 可有效缩短入睡潜伏期。佐匹克隆 2mg 可有效缩短入睡潜伏期和增加睡眠维持时间。佐匹克隆 1mg 和 2mg 剂量可减少老年患者白天小睡的次数并缩短小睡的持续时间。佐匹克隆 2mg 可改善 2 周试验中的情绪、身体健康、家庭活动、用药、休闲活动以及自我报告的身体机能和活力等生活质量指标，还可改善 12 周试验中的活力和总体健康状况。在老年人中最常报告的副作用包括味觉不佳、口干、头晕和嗜睡。同时使用抑制或诱导细胞色素 P450 酶 CYP3A4 的药物会改变佐匹克隆的浓度，可能需要调整剂量。对于入睡困难的患者，佐匹克隆的推荐起始剂量为睡前 1mg。对于抱怨难以维持睡眠的老年人，佐匹克隆应从睡前 2mg 开始使用。总体而言，佐匹克隆是治疗老年失眠患者的一种安全且耐受良好的治疗选择。
