| Objective:To observe the prophylactic effect of Zolpidem improve sleep disorders after acute high-altitude exposure among healthy young men living in the plain entering plateau fast,and to explore the action mechanism of Zolpidem improve high-altitude sleep disorders with detection of blood biochemical indexes and monitoring oxygen saturation.Meanwhile, to assess the prophylactic effect of acute mountain sickness(AMS) by means of Zolpidem improve sleep disorders,so,we measured the change of physical strength and the incidence of AMS in this part of the subjects.The ultimate aim of this study was to seek a safe and effective measures to prevent AMS.Methods:1. Explore the effect of Zolpidem in plateau sleep disorders and its action mechanismWe enrolled a total number of 40 male young adults acute exposed to high-altitude from low altitude according to include and exclude standards in july 2013. 40 research subjects number from 1 to 40,and then divided into Zolpidem group and placebo group according to the method of random Numbers.The does of Zolpidem was 10 mg every day,oral badtime begainning at one night befor acute exposed to high-altitude,and the same as Zolpidem with placebo.Drug were packaged, and numbered by the third party will not be involved the field test,and were sent three days of dose each time,after three days, the durg has not used will be recycle and again to sent next cycle medications.Before acute exposed to high-altitude, 40 subjects were gathered the general information including height and weight by scale, and then detect the Oxygen saturation(SpO2), the Pittsburgh sleep quality index(PSQI) scores and collect the blood samples to analyze the change of GABA and 5-HT.7 days after acute exposed to high-altitude(2 days after the end of taking medicine) by motorize,we gathered the SpO2, the PSQI scores and the blood samples again.2.the effect of oral Zolpidem prevent AMSThe research subjects, randomized method, double-blind method and take medicine method as above.Before acute exposed to high-altitude,we gathered the general information, heart rate(HR),blood pressure(BP), SpO2,the PSQI scores,and physical fitness test including Six-minutes walk test(6MWT), Physical work capacity170(PWC170) and grip strength of two hands.After acute exposed to high-altitude, we gathered the AMS scores at different altitude(3450m,3200 m,4200m and 3900 m respectively), and gathered the HR, BP, SpO2,the PSQI scores, and the physical fitness test again at 7 days after acute exposed to high-altitude(2 days after the end of taking medicine).Results:1. Explore the effect of Zolpidem in Plateau sleep disorders and its action mechanism(1)Sleep quality comparison between the two groups before and after acute exposed to high-altitude.Before acute exposed to high-altitude, there were no significant different in the PSQI total scores, subjective sleep quality scores, sleep latency scores,sleep duration scores, sleep efficiency scores, sleep disturbances scores, daytime dysfunction scores between two test groups(P﹥0.05 respectively).After acute exposed to high-altitude, comparison of sleep quality with the placebo group, Zolpidem group had lower PSQI scores(4.15±2.76 scores) than placebo group(6.58±3.98 scores)( P=0.047).The subjective sleep quality scores and daytime dysfunction scores were significant lower in Zolpidem group than in placebo group((P<0.05 respectively). there were no significant different in sleep latency scores,sleep duration scores, sleep efficiency scores, sleep disturbances scores,between two test groups(P﹥0.05 respectively).After acute exposed to high-altitude,the incidence of sleep disorders were significant lower in Zolpidem group(47.4%) than in placebo group(20%)(P=0.032).(2) the comparison of GABA and 5-HT between the two groups before and after acute exposed to high-altitude.there were no significant different in GABA and 5-HT between two test group in plain and plateau respectively(P>0.05).(3) the comparison of SpO2 between the two groups before and after acute exposed to high-altitude.there were no significant different in SpO2 between two test group in plain and plateau respectively(P>0.05),but after acute exposed to high-altitude,the SpO2 were significant lower in plateau than in plain within the two groups(P<0.05).2.the effect of oral Zolpidem prevent AMS(1) the comparison of HR,BP and SpO2 between the two groups before and after acute exposed to high-altitude.there were no significant different in HR,BP and SpO2 between two test group in plain and plateau respectively(P>0.05 respectively).(2) the comparison of physical fitness between the two groups before and after acute exposed to high-altitude.There were no significant different in 6MWT, PWC170 and grip strength of two hands between two test groups before acute exposed to high-altitude(P>0.05 respectively). Zolpidem group had longer six-minutes walk distance than placebo group after acute exposed to high-altitude(P=0.009),but There were no significant different in PWC170 and grip strength of two hands between two test groups(P﹥0.05 respectively).(3) the comparison of the incidence of AMS between the two groups at different altitude.According to Lake Louise Score(LLS),the incidence of AMS in Zolpidem group were 15%, 10%, 25% and 30% respectively at different altitude(3450m,3200 m,4200m and 3900 m respectively),and the incidence of AMS in placebo group were 52.6%,47.4%,63.2% and 68.4% respectively at different altitude, the incidence of AMS were significant lower in Zolpidem group than in placebo group at different altitude(P<0.05 respectively).According to LLS, the incidence of severe AMS in Zolpidem group were 0,5%,10% and 0 respectively at different altitude(3450m,3200 m,4200m and 3900 m respectively),and the incidence of severe AMS in placebo group were 15.8%,31.6%,42.1% and 26.3% respectively at different altitude, the incidence of severe AMS were significant lower in Zolpidem group than in placebo group at different altitude(P<0.05 respectively).According to LLS, after 20 h of acute exposure to high-altitude,the incidence of AMS symptoms including headache, Gastrointestinal symptoms, weakness and fatigue,dizziness in Zolpidem group were 30%,40%,0 and 30% respectively, the incidence of AMS symptoms in placebo group were 63.2%,63.2%,42.1% and 68.4% respectively. the incidence of AMS symptoms were lower in Zolpidem group than in placebo group, among them,the dizziness, weakness and fatigue symptoms were significant lighter in Zolpidem group than in placebo group(P<0.05 respectively).Conclusions:1.Zolpidem could safely and effectively improve the high-altitude sleep isorders in male young adults acute exposed to high-altitude.2.There were many factors of resulting in a high-altitude sleep disorder,there may be differences on the mechanism of Zolpidem improve sleep disorders between plain and plateau. Explore of the mechanism of its action was not enough in-depth in this study, the mechanism need to be further research.3.Zolpidem could contribute to restores the physical strength and relieve the bad psychological emotions,for example depression,fear and anxiety,in male young adults acute exposed to high-altitude via improving the high-altitude sleep isorders,and than to promote the body to adapt to the high-altitude environment.There may be promote the body to adapt to the high-altitude environment by improving HR,BP and SpO2 during the night.4. After acute exposed to high-altitude, Zolpidem could effectively relieve the symptoms of AMS,meanwhile,it could reduce the incidence of AMS at different altitude.So, Zolpidem was expected to become a new choice for the prevention of AMS. |
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