Effect of zolpidem on sleep and ventilatory patterns at simulated altitude of 4,000 meters

The purpose of this study was to assess the effect of zolpidem 1 0 mg, a new imidazopyridine hypnotic drug, on sleep and respiratory patterns at a simulated altitude of 4,000 meters. Eight male subjects spent three nights in a decompression chamber. The first study night was spent at the ambient pressure corresponding to sea level. The two other nights were spent at a simulated altitude of 4,000 meters with either zolpidem or a placebo in random order according to a double-blind, crossover design. All subjects showed periodic breathing (PB) during sleep at simulated high altitude. Furthermore, altitude was associated with decreases in total sleep time (TST), slow-wave sleep (SWS), and REM sleep, and with significant increases in Stage 1 duration and in the arousal index. Most arousals were synchronous with the hyperpneic phase of PB. The main finding of our study is that zolpidem improved sleep characteristics at high altitude, inducing a decrease in sleep onset latency (placebo, 22 +/- 12 min versus zolpidem, 10 +/- 6 min), an increase in SWS duration (placebo, 46 +/- 28 min versus zolpidem, 69 +/- 28 min), and a reduction in the arousal index during SWS (placebo, 7.4 +/- 4.1 per h versus zolpidem: 2.4 +/- 1.0 per h). Furthermore, none of the respiratory parameters were significantly affected by zolpidem in any sleep stage. In conclusion, zolpidem improved sleep quality at high altitude without adversely affecting respiration.