Sleep Promoting Substances
QINETIQ LTD FARNBOROUGH (UNITED KINGDOM) CENTRE FOR HUMAN SCIENCES
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Adequate sleep is essential to the maintenance of alertness during continuous and sustained operations, and sleep promoting substances or hypnotics have been used successfully in support of demanding scenarios extending over many weeks. The rest periods during such operations are limited in duration and occur at intervals throughout the 24-hour cycle. There are many hypnotics now available, but the necessary profile is limited to a few drugs. These are temazepam 10- 2Omg, zolpidem 10mg and brotizolam 0.125-0.25mg. With each drug there is evidence of efficacy and limited duration of actions with the dose range recommended. Melatonin 5mg also possesses hypnotic activity, with efficacy during the day similar to 2Omg temazepam. However, whereas the benzodiazepines and relate drugs possess hypnotic activity throughout the 24 hour cycle, it would appear that melatonin is only effective when the endogenous plasma levels of naturally occurring melatonin are low, and that ingestion at certain times of day may lead to sleep disturbance. The need to be aware of the constraints on the use of melatonin mitigates against its effectiveness in operations when missions will be required at all times of the day and night with rest periods scattered throughout the 24 hour cycle. As far as military operations are concerned the United Kingdom used the hypnotic temazepam 1 0-2Omg in Royal Air Force personnel during the South Atlantic campaign and during the liberation of Kuwait. It still remains the drug of choice for the Royal Air Force. The recent availability of ultra short acting hypnotics such as zaleplon 10mg has raised the possibility of using hypnotics for shorter sleep periods than 6 hours.
- Stress Physiology