Background/Aims The aim of this study was to study the efficacy and safety of zolpidem for sleep disturbances in patients with cirrhosis.
Methods Fifty-two Child-Turcotte-Pugh (CTP) class A or B cirrhotics with Pittsburgh Sleep Quality Index >5 were randomized to either zolpidem 5 mg daily (n=26) or placebo (n=26) for 4 weeks.
Results The therapy of 4 weeks was completed by 23 patients receiving zolpidem (3 stopped treatment due to excessive daytime drowsiness) and 24 receiving placebo (2 refused to continue the study). In the zolpidem group, after 4 weeks of therapy, there was significant increase in total sleep time (TST) and sleep efficiency compared to baseline and improvement in polysomnographic parameters of sleep initiation and maintenance (i.e., decrease in sleep latency time, decrease in wake time, and decreases in number of arousals and periodic limbs movements per hour of sleep), without any significant change in sleep architecture.
Conclusions Four weeks of 5 mg daily zolpidem in CTP class A or B cirrhosis patients with insomnia led to significant increases in TST and sleep efficiency and improvement in polysomnographic parameters of sleep initiation and maintenance without any significant change in sleep architecture.
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Citations to this article as recorded by
Comprehensive Insight into Analytical Strategies for the Determination of Zolpidem and Its Metabolites in Different Matrices Hemn A.H Barzani, Rebaz Anwar Omer, Nergz Bayiz Abdulrahman, Zanco Hassan Jawhar, Seerwan Hamadameen Sulaiman, Ali Abdulhameed Mohammedsaeed Critical Reviews in Analytical Chemistry.2026; : 1. CrossRef
Auricular Acupressure for Insomnia in Patients with Decompensated Hepatitis B-Related Liver Cirrhosis: A Clinical Observation Xiaotong Du, Jingfang Hu, Qi Feng, Shuang Liang, Shuhui Zhao, Feifei Liu Acupuncture & Electro-Therapeutics Research: International Journal of Integrated Medicine.2026; 50(4): 611. CrossRef
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Fatigue, weakness, and sleep disturbances in liver disease: Diagnosis and patient management K. L. Raikhelson, M. G. Poluektov, D. S. Petelin, A. F. Sheptulina Meditsinskiy sovet = Medical Council.2026; (13): 124. CrossRef
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Management of fatigue and sleep disorders in patients with chronic liver disease Sebastian Niezen, Alan Noll, Judith Bamporiki, Shari S. Rogal Clinical Liver Disease.2024;[Epub] CrossRef
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Sleep disturbances in patients with cirrhosis: Pursuing just right Yangyang Hui, Xin Chen, Chao Sun Portal Hypertension & Cirrhosis.2023; 2(4): 181. CrossRef
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Case Report: High doses of Zolpidem and QT interval lengthening: Is there a relationship? A case series Simone Campagnari, Lorenzo Zamboni, Francesca Fusina, Rebecca Casari, Fabio Lugoboni Frontiers in Psychiatry.2022;[Epub] CrossRef
Comprehensive Overview of Sleep Disorders in Patients with Chronic Liver Disease Oana-Mihaela Plotogea, Madalina Ilie, Simona Bungau, Alexandru Laurentiu Chiotoroiu, Ana Maria Alexandra Stanescu, Camelia Cristina Diaconu Brain Sciences.2021; 11(2): 142. CrossRef
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