Trials of hypnotic medications typically determine efficacy by examining
changes in polysomnographically recorded sleep and in daytime performance.
The authors employed daytime sleepiness as a new, potentially crucial
criterion in such trials. Oxazepam and flurazepam were effective in
improving some polysomnographically defined measures of nocturnal sleep in
14 patients with chronic insomnia; flurazepam produced substantial daytime
sleepiness and oxazepam did not. Oxazepam produced some rebound insomnia,
consisting of about an hour's reduction of polysomnographically defined
sleep, but without gross mood disturbance or the patients' awareness of
sleep loss.
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