title: Prevalence and clinical correlates of flunitrazepam-related complex sleep behaviors.
abstract: OBJECTIVE
  Complex sleep behaviors (CSB) are often associated with the use of hypnotic drugs. This study investigated the prevalence and correlates of CSB among psychiatric patients who were given flunitrazepam.
  
  
  METHODS
  From June 2011 to May 2012, a total of 268 psychiatric outpatients who had received flunitrazepam for at least 3 months were enrolled. Data on occurrence of CSB, demographic characteristics, flunitrazepam dosage and duration of use, psychiatric diagnoses, physical illnesses, and alcohol use were collected. Logistic regression analysis was used to examine the clinical correlates of CSB.
  
  
  RESULTS
  Sixty-six participants (24.6%) reported experiencing CSB. Logistic regression analysis showed that a high dosage (>2 mg/day) of flunitrazepam (odds ratio [OR] = 1.941, 95% confidence interval [CI] = 1.090-3.455, P = 0.024) and alcohol use (OR = 1.948, 95%CI = 1.023-3.709, P = 0.042) were significantly associated with the occurrence of CSB. Sex, age, duration of flunitrazepam use, psychiatric diagnoses, and physical illnesses were not significantly associated with the occurrence of CSB.
  
  
  CONCLUSIONS
  CSB among flunitrazepam users should be monitored routinely, especially among those receiving a high dosage who also consume alcohol.
authors: Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors: Jui-Kang
authors: JK
authors: Tsai
authors: Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Executive Yuan, Tainan, Taiwan.
authors: Chia-Nan
authors: CN
authors: Yen
authors: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Psychiatry, College of Medicine, and Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Cheng-Sheng
authors: CS
authors: Chen
authors: Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.|Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan.
authors: Tzung-Jeng
authors: TJ
authors: Hwang
authors: School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan.|Department of Psychiatry, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors: Shao-Tsu
authors: ST
authors: Chen
authors: Department of Psychiatry, Yun-Lin Branch, National Taiwan University Hospital, Yunlin, Taiwan.
authors: Tzu-Ting
authors: TT
authors: Chen
authors: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Psychiatry, College of Medicine, and Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Chih-Hung
authors: CH
authors: Ko
authors: Department of Psychiatry, Puzi Hospital, Ministry of Health and Welfare, Executive Yuan, Chiayi, Taiwan.
authors: Po-Wen
authors: PW
authors: Su
authors: Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan.
authors: Yu-Ping
authors: YP
authors: Chang
authors: Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan.
authors: Jin-Jia
authors: JJ
authors: Lin
authors: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Psychiatry, College of Medicine, and Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Cheng-Fang
authors: CF
authors: Yen
mesh_terms: D000328:Adult; D005260:Female; D005445:Flunitrazepam / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*
chemical_list: D006993:Hypnotics and Sedatives; D005445:Flunitrazepam
keywords: alcohol use; complex sleep behaviors; dosage; flunitrazepam; prevalence