Verster Joris C, van de Loo Aurora J A E, Moline Margaret L, Roth Thomas
Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacology, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands.
Curr Drug Saf. 2014;9(3):205-11. doi: 10.2174/1574886309666140601210422.
Sleep maintenance problems are common, hence treatments enabling patients to fall asleep more rapidly after middle-of-the-night (MOTN) awakenings, without impairing next morning alertness, are needed. This literature review compares the effects of MOTN administration of various hypnotics on morning driving ability, a potentially dangerous daily activity under conditions of impairment.
A literature search was conducted identifying on-the-road driving studies examining the effects of MOTN administration of hypnotics on morning driving performance. In a standardized 100-km highway driving test in normal traffic, subjects were instructed to drive with a steady lateral position and constant speed of 95 km/h. The primary outcome measure of the driving test is the Standard Deviation of Lateral Position (SDLP, cm), i.e. weaving of the car.
Four driving studies were identified. Driving performance after MOTN administration of traditional benzodiazepine hypnotics was not examined. Zolpidem (10 mg and 20 mg, oral immediate release tablets) significantly impaired driving in a dose-dependent manner, when tested 4 hours after MOTN administration. Also, gaboxadol (15 mg) and zopiclone (7.5 mg) significantly impaired next-morning driving after MOTN administration. In contrast, sublingual zolpidem (3.5 mg) and zaleplon (10 mg and 20 mg) did not significantly affect driving 4 hours after MOTN administration.
Driving was not affected 4 hours after MOTN administration of sublingual zolpidem (3.5 mg) or zaleplon (10 mg and 20 mg). Significant driving impairment was found after MOTN administration of zolpidem (10 and 20 mg), gaboxadol (15 mg), and zopiclone (7.5 mg).
睡眠维持问题很常见，因此需要有能让患者在半夜醒来后更快入睡且不影响次日早晨警觉性的治疗方法。这篇文献综述比较了半夜服用各种催眠药对早晨驾驶能力的影响，早晨驾驶是在机能受损情况下一项有潜在危险的日常活动。
进行文献检索，找出研究半夜服用催眠药对早晨驾驶表现影响的道路驾驶研究。在正常交通状况下进行的标准化100公里高速公路驾驶测试中，要求受试者保持稳定的横向位置并以95公里/小时的恒定速度驾驶。驾驶测试的主要结果指标是横向位置标准差（SDLP，厘米），即汽车的摆动情况。
共找到四项驾驶研究。未对半夜服用传统苯二氮䓬类催眠药后的驾驶表现进行研究。唑吡坦（10毫克和20毫克，口服速释片）在半夜服用4小时后进行测试时，以剂量依赖方式显著损害驾驶能力。此外，加波沙朵（15毫克）和佐匹克隆（7.5毫克）在半夜服用后显著损害次日早晨的驾驶能力。相比之下，舌下含服唑吡坦（3.5毫克）和扎来普隆（10毫克和20毫克）在半夜服用4小时后对驾驶没有显著影响。
半夜服用舌下含服唑吡坦（3.5毫克）或扎来普隆（10毫克和20毫克）4小时后驾驶未受影响。半夜服用唑吡坦（10毫克和20毫克）、加波沙朵（15毫克）和佐匹克隆（7.5毫克）后发现有显著的驾驶能力损害。
