Daytime sleep and performance following a zolpidem and melatonin cocktail

Nancy Jo Wesensten; Thomas J Balkin; Rebecca M Reichardt; Mary A Kautz; George A Saviolakis; Gregory Belenky

doi:10.1093/sleep/28.1.93

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Daytime sleep and performance following a zolpidem and melatonin cocktail

Journal article

Open access

Daytime sleep and performance following a zolpidem and melatonin cocktail

Nancy Jo Wesensten, Thomas J Balkin, Rebecca M Reichardt, Mary A Kautz, George A Saviolakis and Gregory Belenky

Sleep (New York, N.Y.), Vol.28(1), pp.93-103

01/2005

DOI: https://doi.org/10.1093/sleep/28.1.93

Handle:

https://hdl.handle.net/2376/113384

PMID: 15700725

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Abstract

Wakefulness - drug effects

Humans

Hypnotics and Sedatives - administration & dosage

Male

Saliva - chemistry

Melatonin - administration & dosage

Adult

Female

Antioxidants - analysis

Melatonin - analysis

Pyridines - administration & dosage

Double-Blind Method

Psychomotor Performance - drug effects

Antioxidants - pharmacology

Mental Recall - drug effects

Circadian Rhythm

Cognition - drug effects

Sleep - drug effects

Adolescent

Antioxidants - administration & dosage

Zolpidem

Hypnotics and Sedatives - pharmacology

Pyridines - pharmacology

Melatonin - pharmacology

Drug Combinations

Pharmacologic enhancement of daytime sleep may help sustain optimal cognitive performance. At effective doses, zolpidem induces sleep but also impairs performance. Combining melatonin with low-dose zolpidem may promote daytime sleep without exacerbating performance impairments seen with high-dose zolpidem alone. Following an 8-hour undisturbed nighttime sleep period, 80 subjects (50 men, 30 women) were administered oral zolpidem 0, 5, 10, or 20 mg at 10:00 am (n = 20 per group) and then oral melatonin 0 or 5 mg at 10:30 am (thus, n = 10 per drug combination) in a double-blind randomized fashion. Subjects napped from 10:00 am to 11:30 am, at which time they were awakened and cognitive tests administered (Restricted Reminding, Paired-Associates, and Psychomotor Vigilance). A second nap ensued from 12:45 pm to 4:00 pm, followed immediately by further testing. Melatonin 5 mg plus zolpidem 0 mg enhanced daytime sleep (P < .05) with no memory or performance impairment (P > .05). Zolpidem 20 mg plus melatonin 0 mg also enhanced daytime sleep (albeit nonsignificantly), but memory and vigilance were impaired (P < .05). Melatonin's sleep-promoting effects were not evident until the second nap. No advantages to administering melatonin plus zolpidem "cocktails" were evident. Unlike zolpidem, melatonin 5 mg alone improved daytime sleep without impairing memory and vigilance. Functional coupling of sleep-inducing and memory-impairing effects may be specific to benzodiazepine-receptor agonists such as zolpidem, suggesting potential advantages to using melatonin in the operational environment. That melatonin's sleep-promoting effects were delayed for several hours presents a practical consideration that may limit melatonin's usefulness when daytime sleep periods cannot be reliably anticipated or planned in advance.

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Title: Daytime sleep and performance following a zolpidem and melatonin cocktail
Creators: Nancy Jo Wesensten - Department of Behavioral Biology, Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910-7500, USA. nancy.wesensten@us.army.mil
Thomas J Balkin
Rebecca M Reichardt
Mary A Kautz
George A Saviolakis
Gregory Belenky
Publication Details: Sleep (New York, N.Y.), Vol.28(1), pp.93-103
Academic Unit: Medical Education and Clinical Science, Department of
Publisher: United States
Identifiers: 99900548290001842
Language: English
Resource Type: Journal article