Abstract: Long-term use of benzodiazepine agonists is
widespread, although guidelines recommend short-term use. Only few controlled
studies have characterized the effect of discontinuation of their chronic use on
sleep and quality of life. We studied perceived sleep and quality of life in 92
older (age 55-91) outpatients with primary insomnia before and after withdrawal
from long-term use of zopiclone, zolpidem or temazepam (BZDA). BZDA was withdrawn during one
month, during which the participants received psychosocial support and blindly melatonin
or placebo. An extensive questionnaire was used to study perceived sleep and
quality of life before withdrawal (baseline), and 1 month and 6 months later. 89
participants completed the 6-month follow-up. As melatonin did not improve
withdrawal, all participants were pooled and then separated based on the
withdrawal results at 6 months (34 Withdrawers versus 55 Nonwithdrawers) for this
secondary analysis. At 6 months, the Withdrawers had significantly (p < 0.05) shorter sleep onset latency and less difficulty in initiating
sleep than at baseline and when compared to Nonwithdrawers. Compared to baseline, both Withdwavers and Nonwithdrawers
had at 6 months significantly (p <
0.05) less fatigue during the morning and daytime. Stress was alleviated more
in Withdrawers than in Nonwithdrawers (p
< 0.05). Satisfaction with life and expected health one year later improved (p < 0.05) in Withdrawers. In
conclusion, perceived sleep disturbances, day-time fatigue, and impaired
quality of life may resolve within 6 months of BZDA withdrawal. These results encourage withdrawal from
chronic use of benzodiazepine-type hypnotics, particularly in older subjects.