Feasibility of an every-other-night regimen in insomniac patients: subjective hypnotic effectiveness of quazepam, triazolam, and placebo.

BACKGROUND: Rebound insomnia, a worsening of sleep difficulty beyond baseline levels, can complicate the physician's attempt to use regularly scheduled drug holidays in the management of insomniac patients. Quazepam, a benzodiazepine with a long half-life, has been shown to exhibit carryover effectiveness for the first night or two following withdrawal. This finding suggests a potential utility for an alternate-night drug regimen in which the withdrawal features of the compound serve as a potential benefit.

METHOD: A randomized, double-blind, three-compartment, parallel-group design of 5 weeks' duration, comparing quazepam 15 mg, triazolam 0.5 mg, and placebo, was conducted in 65 insomniac subjects. This study was a nonpolysomnographic study utilizing sleep questionnaires.

RESULTS: No differences were noted between quazepam and triazolam on treatment nights. Evidence of carryover effectiveness with quazepam and rebound effects with triazolam were noted on off-treatment nights.

CONCLUSION: The efficiency of alternate-night therapy with quazepam should be rigorously evaluated using polysomnographic determinations.