Acutely shifting the sleep-wake cycle: nighttime sleepiness after diurnal administration of temazepam or placebo

Abstract

Hypothesis: Sleepiness on the job is a common problem suffered by people involved in night shift work, especially in conditions of abrupt reversal of the sleep-wake cycle, such as emergencies and combat air operations. It is well known that sleepiness can severely affect alertness and performance. One of the most useful countermeasures is to take a prophylactic nap before working at irregular hours. To induce and maintain sleep in the "forbidden zones for sleep" during the day, it is possible to use suitable benzodiazepine hypnotics such as temazepam (TMZ). However, it is then necessary to monitor sleepiness and performance the night following the diurnal intake of the drug in order to evaluate possible side effects.

Methods: In this study, sleepiness was subjectively and objectively measured during the night after a daytime administration of TMZ 20 mg in soft gelatine capsules or placebo to obtain a prophylactic sleep.

Results and discussion: Results showed the effectiveness of TMZ for inducing and maintaining diurnal sleep. This lengthening of total sleep time did not cause a decrease of sleepiness during the night, but no significant carry over effect of TMZ was present for nighttime sleep tendency. Both polygraphic and subjective measures of sleep latency decreased during the night. Finally, no significant relationship between the Stanford Sleepiness Scale and the Multiple Sleep Latency Test measures was found.