title: Clinical correlates of zolpidem-associated complex sleep-related behaviors: age effect.
abstract: OBJECTIVE
  Complex sleep-related behaviors (CSBs) are often associated with hypnotic use, especially zolpidem. The age effect on the occurrence of CSBs has not been adequately investigated. This study aimed to investigate and compare the clinical correlates of CSBs between adult and elderly subjects who were taking zolpidem.
  
  
  METHODS
  A total of 253 adults (aged 20-55 years) and 64 elderly subjects (aged ≥ 65 years) who were administered zolpidem for at least 3 months were enrolled from psychiatric outpatient clinics from June 2011 to May 2012. The sociodemographic characteristics of the participants, the dose of zolpidem, and the occurrence of CSBs were collected. Logistic regression analysis was used to examine the clinical correlates of CSBs.
  
  
  RESULTS
  In total, there were 62 members of the adult group (24.5%) and 11 elderly subjects (17.2%) with CSBs; however, the difference did not reach statistical significance. Logistic regression analysis showed that there was a main effect of zolpidem dose (≥ 10 mg; OR = 2.82, P = .038) and alcohol use (OR = 2.05, P = .026), but not sex or age group. There were interactive effects between age group and zolpidem dose (P = .043), indicating that a higher dose of zolpidem was associated with CSBs only in the adult group and not in the elderly group. Adults with CSBs used a higher dose of zolpidem than adults without (mean ± SD: 15.4 ± 6.8 mg vs 11.3 ± 5.7 mg), whereas elderly patients with CSBs did not use a higher dose of zolpidem than those without (12.2 ± 5.4 mg vs 11.9 ± 7.0 mg).
  
  
  CONCLUSIONS
  A higher dose of zolpidem was correlated with CSBs only in the adult group and not in the elderly group. Future studies investigating the factors, other than dose, related to CSBs in the elderly will be performed.
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, and Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung.
authors.forename: Cheng-Sheng
authors.initials: CS
authors.lastname: Chen
authors.forename: Mei-Feng
authors.initials: MF
authors.lastname: Huang
authors.forename: Tzung-Jeng
authors.initials: TJ
authors.lastname: Hwang
authors.forename: Shao-Tsu
authors.initials: ST
authors.lastname: Chen
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Ko
authors.forename: Chia-Nan
authors.initials: CN
authors.lastname: Yen
authors.forename: Tzu-Ting
authors.initials: TT
authors.lastname: Chen
authors.forename: Po-Wen
authors.initials: PW
authors.lastname: Su
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Yeh
authors.forename: Jin-Jia
authors.initials: JJ
authors.lastname: Lin
authors.forename: Cheng-Fang
authors.initials: CF
authors.lastname: Yen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D020447:Parasomnias / Q000139:chemically induced*; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects*; D055815:Young Adult; D000077334:Zolpidem
chemical_list: D006993:Hypnotics and Sedatives; D011725:Pyridines; D000077334:Zolpidem