Effect of triazolam on responses to a cold-water immersion in humans

Managing alertness of soldiers during sustained operations is a source of serious concern for military unit commanders. A frequently employed strategy is to induce sleep before an operation, especially operations requiring prolonged travel. Sleep-inducing drugs could have an action on thermoregulation through their effect on alertness and a possible direct effect on the brain. The goal of this study was therefore to evaluate the effect of a commonly prescribed triazolam (Halcion) on thermoregulatory responses to cold-water immersion. Eight subjects were immersed twice in 18 degrees C water for up to 90 min in the morning; once after ingesting 0.25 mg triazolam (TRZ) the prior evening, and again after placebo (PLB) treatment. There were no significant differences between trials for mean duration of the immersion, the change in rectal temperature and mean skin temperature. Total metabolic heat production was similar for both conditions: 767 +/- 107 vs. 781 +/- 105 kj.m-2 for TRZ and PLB, respectively. The results should be considered in light of a large variation among the subjects in sensitivity to TRZ, which was unrelated to biometrical characteristics such as surface area-to-mass ratio, lean body mass, % body fat, and physical fitness. Although not statistically significant, there was a trend for a smaller increase in plasma free fatty acid and glycerol concentrations after water immersion with TRZ. The results suggest that the ingestion of a single dose of triazolam 11 h prior to a cold-water immersion is not likely to accelerate the rate of onset of hypothermia. Individual sensitivity, however, may predispose some sensitive subjects to negative effects in this regard.