Cognitive functioning in a hypnotic drug trial

In a 2 week comparative trial between lormetazepam (LMA) and temazepam (TEM) in 162 insomniac patients, Critical Flicker Fusion Threshhold (CFFT) and Digit Symbol Substitution (DSS) tests were performed, pre‐treatment and at days 7 and 14. With neither drug was there any difference in CFFT, but highly significant improvement in DSS ( p < 0.001). Patients completed daily visual analogue scales concerned with various sleep parameters and daytime effects. Sleep was significantly improved with both drugs from day 1 onwards, as were daytime general wellbeing and alertness. There was significant improvement in daytime balance and coordination in the LMA group ( p < 0·001 by day 14) but not in the TEM group. Daytime anxiety improved significantly in both groups, but on day 14 this improvement was still significant in the LMA group ( p < 0·001) but not in the TEM group. The incidence of daytime fatigue ( p < 0·001), drowsiness ( p < 0·02) and headache ( p < 0·001) were significantly reduced with LMA and daytime fatigue ( p < 0·01) and headache ( p < 0·001) with TEM, but with no significant between group differences. The severity of daytime fatigue was significantly less with LMA than with TEM ( p < 0·05).