Insomnia Clinical Trial
Official title:
Single Dose Pharmacokinetic and Pharmacodynamic Evaluation of Three Different Zolpidem Doses in Children Ages 2 to 18 Years of Age
This is a multicenter trial to evaluate the single-dose safety, tolerability and pharmacokinetics-pharmacodynamics of Zolpidem in a group of children with sleep disturbances stratified by age and dose.
The consequences of sleep deprivation to the productivity of the individual and society are
extensive. (Most clinicians and patients believe that insomnia becomes a clinical problem
requiring therapy when excessive daytime sleepiness impairs cognition and mood, interfering
with a patient's performance of functions that require alertness. Chronic sleep deprivation
often leads to adverse personal, medical and psychiatric complications, underscoring the
common request of patients for treatment by their physician.
With an increasing focus on the problem of sleep deprivation in children of all ages, our
appreciation of the scope of the problem is expanding. It is estimated that up to 40 % of
infants experience difficulty in settling and frequent nighttime wakings with sleep
disturbances including bedtime resistance, delayed onset of sleep, and disruptive night
wakings occurring in 25 to 50 % of preschoolers. In school-aged children, parents reported
an incidence of bedtime resistance in 15 % of their children.
Very limited data exist describing the pharmacokinetics of zolpidem in pediatrics. Colle and
colleagues reported the zolpidem clearance to be 3 times greater in children (n=6) compared
to young adults (n=104) though Cmax and AUC values were similar despite a higher zolpidem
dose (mg/Kg) in the children. Unfortunately these data raise more questions than they answer
regarding zolpidem disposition relative to age and highlight the need to comprehensively
determine zolpidem disposition characteristics across a broad age range of pediatric
subjects.
In summary, although researchers have been hesitant to include children in drug studies, the
data indicate that pediatric sleep disturbance have a negative health impact on children and
warrant pharmacologic intervention. Studies to identify the appropriate drug and dosage for
children of all ages are essential in addressing this health problem that impacts the child
and his/her family.
;
Allocation: Randomized, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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