Effects of Zolpidem on Sleep Quality and Quality of Life in Stroke Patients with Comorbid Depression
A. StarcevicIntroduction
Post-stroke insomnia and depression are prevalent, negatively impacting rehabilitation and quality of life (QoL). Zolpidem, a non-benzodiazepine hypnotic, is commonly used for insomnia but its effects in stroke patients with comorbid depression remain underexplored.
Objectives
This study investigates the efficacy and safety of zolpidem in improving sleep quality and QoL in this population.
Methods
In a randomized, double-blind, placebo-controlled trial, 60 post-acute ischemic stroke patients, both genders, (aged 45–75 years) with DSM-5 diagnosed insomnia and comorbid depression were assigned to receive either zolpidem (10 mg) or placebo nightly for 4 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). QoL was evaluated using the Short Form Health Survey (SF-36). Secondary outcomes included depression severity (Hamilton Depression Rating Scale, HAM-D) and adverse events. Assessments were conducted at baseline and after four weeks.
Results
Zolpidem significantly improved sleep quality compared to placebo, with a mean PSQI score reduction of 4.8 ± 1.2 vs. 1.9 ± 0.8 (p < 0.001) and ISI score reduction of 6.2 ± 1.5 vs. 2.3 ± 1.0 (p < 0.01). SF-36 scores showed greater improvement in physical (p = 0.02) and mental (p = 0.01) QoL domains in the zolpidem group. HAM-D scores decreased significantly in the zolpidem group (p = 0.03), suggesting a potential indirect effect on depression. Side effects (dizziness, daytime drowsiness) were mild and occurred in 10% of the zolpidem group vs. 5% of the placebo group, with no serious side effects reported.
Conclusions
Zolpidem is effective in improving sleep quality and QoL in stroke patients with comorbid depression, with a favorable safety profile. These findings support its potential as a therapeutic option in this population, warranting further investigation into long-term effects and optimal dosing strategies.
Keywords
Zolpidem, insomnia, stroke, depression, quality of life, sleep quality
Disclosure of Interest
None Declared