title: Comparing effects of clonazepam and zolpidem on sleep quality of patients on maintenance hemodialysis.
abstract: BACKGROUND
  Poor sleep quality is very common among maintenance hemodialysis patients and has negative impacts on patients' quality of life. Benzodiazepines have traditionally been used in this population; however, they may induce physical dependence and sleep apnea. Nonbenzodiazepine hypnotic medications with less side effects are introduced as alternatives. This study was designed to compare the effect of zolpidem and clonazepam on sleep quality of hemodialysis patients.
  
  
  METHODS
  In a randomized crossover study on 23 hemodialysis patients, sleep quality was assessed using the Pittsburgh Sleep Quality Index at baseline, at the initiation of a 1-week washout period after a 2-week treatment with zolpidem (1 mg) and clonazepam (5 mg to 10 mg), and after the second 2 weeks of treatment. Patients who suffer from any concurrent situations that may affect sleep quality or psychiatric disorders and those on medications affecting sleep quality were excluded.
  
  
  RESULTS
  The prevalence of poor sleep quality was 87.8% of the 88 hemodialysis patients who were initially approached. There was a significant negative correlation between iron deficiency and poor sleep quality. Both clonazepam and zolpidem significantly improved sleep quality; however, clonazepam was more effective in decreasing the Pittsburgh Sleep Quality Index scores (P = .03). Zolpidem was better tolerated in the hemodialysis patients.
  
  
  CONCLUSIONS
  Clonazepam was more effective than zolpidem in the improvement of sleep quality of hemodialysis patients, while zolpidem was better tolerated in these patients.
authors: Department of Clinical Pharmacy, Faculty of Pharmacy and Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. dashtis@sina.tums.ac.ir
authors: Simin
authors: S
authors: Dashti-Khavidaki
authors: Nastaran
authors: N
authors: Chamani
authors: Hossein
authors: H
authors: Khalili
authors: Azita
authors: A
authors: Hajhossein Talasaz
authors: Farokhlegha
authors: F
authors: Ahmadi
authors: Mahboob
authors: M
authors: Lessan-Pezeshki
authors: Padideh
authors: P
authors: Ghaeli
authors: Shirin
authors: S
authors: Dalili
authors: Abbas
authors: A
authors: Alimadadi
mesh_terms: D000328:Adult; D000368:Aged; D002998:Clonazepam / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D018757:GABA Modulators / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011725:Pyridines / Q000008:administration & dosage*; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects*; D012890:Sleep / Q000187:drug effects*; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D000077334:Zolpidem
chemical_list: D018757:GABA Modulators; D006993:Hypnotics and Sedatives; D011725:Pyridines; D002998:Clonazepam; D000077334:Zolpidem