Abstract
BackgroundWhile an association between zolpidem use and fracture and road accident was previously proposed, this study aimed to further explore the frequency and risk of a wide spectrum of injuries in subjects prescribed with zolpidem in Taiwan.MethodsWe identified 77,036 subjects who received Zolpidem treatment between 2005 and 2007. We randomly selected 77,036 comparison subjects who were frequency-matched based-on their demographic profiles. We individually tracked each subject for a 90-day period to identify those who subsequently suffered an injury. Cox proportional hazards regressions were performed to calculate the hazard ratio of injury between the two groups.ResultsThe incidence rate of injury during the 90-day follow-up period for the total subjects was 18.11 (95% CI = 17.69–18.54) per 100 person-years; this was 24.35 (95% CI = 23.66–25.05) and 11.86 (95% CI = 11.39–12.36) for the study and comparison cohort, respectively. After adjusting for demographic variables, the hazard ratio (HR) of injury during the 90-day follow-up period for study subjects was 1.83 (95% CI = 1.73–1.94) that of comparison subjects. Additionally, compared to comparison subjects, the adjusted HR of injury during the 90-day follow-up period for study subjects who were prescribed Zolpidem for >30 days was as high as 2.17 (95% CI = 2.05–2.32). The adjusted HR of injury to blood vessels for study subjects was particularly high when compared to comparison subjects (HR = 6.34; 95% CI = 1.37–29.38).ConclusionsWe found that patients prescribed with Zolpidem were at a higher risk for a wide range of injuries.
Highlights
Zolpidem is a short-acting non-benzodiazepine drug used to treat insomnia
The log-rank test suggested that study subjects had a significantly lower 90day injury-free survival rate than comparison subjects (p,0.001)
After adjusting for geographic region, monthly income, co-morbidities, and propensity score, the hazard ratio (HR) of injury during the 90-day follow-up period for study subjects was 1.83 that of comparison subjects
Summary
Zolpidem is a short-acting non-benzodiazepine drug used to treat insomnia. The onset of zolpidem is fast, which is suitable for subjects who have difficulty initiating sleep [1]. It is increasingly recognized that some parasomnia, such as sleepeating, sleep-walking, and sleep-driving occurs among some patients taking zolpidem [9]. These unconscious behaviors during sleep may cause severe self-injury and raise concerns regarding the safety of zolpidem. Several studies have reported that an increased risk for fracture and road accidents can still be found among subjects who used zolpidem [10,11]. While an association between zolpidem use and fracture and road accident was previously proposed, this study aimed to further explore the frequency and risk of a wide spectrum of injuries in subjects prescribed with zolpidem in Taiwan
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