Shelton P S, Hocking L B
Department of Pharmacy Practice, Campbell University School of Pharmacy, Buies Creek, NC, USA.
Ann Pharmacother. 1997 Mar;31(3):319-22. doi: 10.1177/106002809703100309.
To describe two elderly patients with dementia and severe nighttime wandering in whom zolpidem restored normal sleep patterns.
A 90-year-old African-American woman (case 1) and an 87-year-old African-American man (case 2) presented with nighttime wandering associated with the progression of Alzheimer-like dementia. Both patients had previously not responded to bedtime regimens of benzodiazepines, trazodone (an antidepressant used for its sedative properties), and neuroleptics. Both patients averaged 2-3 hours of sleep each night. Low-dose zolpidem (5 mg hs) was initiated with only partial response. The dosage was titrated in 5-mg increments until the optimum dosage was reached for case 1 (15 mg hs) and case 2 (10 mg hs). These dosages have proven to be effective over a period of 3 months, with both patients averaging 7-8 hours of sleep each night with no apparent adverse effects.
Dementia produces inversion of the circadian sleep/ wake cycle, leading to daytime sedation and nighttime wandering. Zolpidem, a nonbenzodiazepine hypnotic with proven safety and efficacy in older patients with insomnia, was well tolerated and improved sleep patterns in two patients with dementia and severe nighttime wandering.
Zolpidem appears to be useful for restoring normal sleep patterns in elderly patients with dementia and nighttime wandering.
描述两名患有痴呆症且夜间严重徘徊的老年患者，唑吡坦使他们恢复了正常睡眠模式。
一名90岁非裔美国女性（病例1）和一名87岁非裔美国男性（病例2）因类似阿尔茨海默病痴呆症的进展而出现夜间徘徊。两名患者之前对苯二氮䓬类药物、曲唑酮（一种因其镇静特性而使用的抗抑郁药）和抗精神病药的睡前用药方案均无反应。两名患者每晚平均睡眠2至3小时。开始使用低剂量唑吡坦（5毫克，睡前服用），仅部分有效。剂量以5毫克的增量滴定，直到病例1（15毫克，睡前服用）和病例2（10毫克，睡前服用）达到最佳剂量。这些剂量在3个月内已被证明有效，两名患者每晚平均睡眠7至8小时，且无明显不良反应。
痴呆症会导致昼夜睡眠/觉醒周期倒置，导致白天嗜睡和夜间徘徊。唑吡坦是一种非苯二氮䓬类催眠药，在老年失眠患者中已证实具有安全性和有效性，在两名患有痴呆症且夜间严重徘徊的患者中耐受性良好并改善了睡眠模式。
唑吡坦似乎有助于恢复患有痴呆症和夜间徘徊的老年患者的正常睡眠模式。
