Effects of Triazolam on the Perception of Sleep and Wakefulness in Insomniacs

AbstractAlthough the short-acting benzodiazepines are the most widely used hypnotics in the world, the mechanism by which they induce a sense of improved sleep remains obscure. In order to determine whether triazolam alters the perception of being asleep, we have performed auditory arousal threshold measures on chronic insomniacs during waking and sleeping at five points through the night, and then questioned them regarding their subjective experience prior to each forced arousal. As expected, triazolam 0.25 mg resulted in increased EEG or behavioral arousal thresholds 5 minutes after “lights out,” during stage 2 sleep 10 minutes after the first sleep spindle, and during spontaneous waking time. As with other benzodiazepine hypnotics, the arousal thresholds in stage 2 on active drug nights exceeded the amplitude of common commercial smoke alarms. Patients reported having been awake during the stage 4 trial in 50% of the cases after placebo, but only 8% after 0.25 mg triazolam (p < 0.02). After triazolam, ...