Benzodiazepine Activity: Daytime Effects and the Sleep EEG.
Interim rept. Sep 78-Jun 84,
NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA
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In this paper we review the effects of benzodiazepine hypnotics on the structure of sleep, arousal threshold during sleep, and the impact of bedtime hypnotic use on next-day performance. We also describe the effects of discontinuation of use of long and short half-life sedative-hypnotics. Results indicate that the half-life of benzodiazepine hypnotics is not the best predictor of next-day performance effects, arousal threshold effects, or the nature of EEG changes during sleep. Other pharmacokinetic properties, such as volume of distribution, must also be considered. Long and short half-life benzodiazepines both may produce a rebound insomnia, although the time of occurrence seems to differ. The marked individual differences in response to similiar drug plasma levels plus processes of tolerance and adaptation limit the probability that significant correlations during chronic use. Dose level is the best predictor of next-day effects, and so, the smallest effective dose should be described.