title: Sleep architecture in insomniacs with severe benzodiazepine abuse.
abstract: Benzodiazepines (BZDs) are the most commonly prescribed compounds in insomnia. A long-term of BZDs use may cause dependence and abuse. The aim of this study was to evaluate sleep architecture and microstructure (in terms of cyclic alternating pattern - CAP - analysis and of sleep EEG power spectral analysis) in a group of long-term users of high doses of BZDs for their primary chronic insomnia.
  
  
  
  Twenty patients consecutively admitted at the Sleep Centre for drug discontinuation and 13 matched healthy controls underwent a full nocturnal video-polysomnographic recording, after one adaptation night.
  
  
  
  Significant differences were found in time in bed, REM sleep latency and sleep stage 1% which were increased in patients compared to controls, while CAP rate was dramatically decreased. During NREM sleep, patients showed a clear decrease in the relative power of delta band.
  
  
  
  Our data demonstrate that in adults with chronic insomnia, long-term use of high doses of BZDs induces a severe disruption of sleep microstructure, while sleep architecture seems to be much less affected.
  
  
  
  The long term use of high doses of BZDs for chronic insomnia induces a marked depression of slow wave activity and of its physiological instability.
authors.affiliation: Sleep and Epilepsy Center, Neurocenter of the Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland. Electronic address: mauro.manconi@eoc.ch.
authors.forename: Mauro
authors.initials: M
authors.lastname: Manconi
authors.affiliation: Sleep Research Centre, Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
authors.affiliation: Sleep and Epilepsy Center, Neurocenter of the Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland.
authors.forename: Silvia
authors.initials: S
authors.lastname: Miano
authors.affiliation: Sleep and Epilepsy Center, Neurocenter of the Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland; Department of Neurosciences, Neurological Clinic, University of Pisa, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Maestri
authors.affiliation: Sleep Disorders Center, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Bottasini
authors.affiliation: Sleep Disorders Center, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zucconi
authors.affiliation: Sleep Disorders Center, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
mesh_terms: D000328:Adult; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D058256:Brain Waves; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067490:Prescription Drug Overuse / Q000009:adverse effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000503:physiopathology*; D012895:Sleep, REM
chemical_list: D001569:Benzodiazepines
keywords: Benzodiazepine; Cyclic alternating pattern; Insomnia