Zolpidem and Sleep in Pediatric Burn Patients With ADD/HD
Zolpidem and Sleep in Pediatric Burn Patients With ADD/HD
A retrospective chart review was conducted of all children with acute burn injuries with a length of stay greater than three days admitted to Shriners Hospitals for Children in Cincinnati, Ohio, between the years 2005 and 2011 (N = 320). A review of each patient's diagnostic coding, nursing admission history, psychiatric consultation, as well as physician's notes, was performed to identify all patients with a pre-burn diagnosis of ADHD. These charts were examined to isolate those patients initially placed on zolpidem for sleep disturbances. The medical records of 205 children admitted for burn care were identified as being coded for ADHD; however, only 23 of these patients were initially placed on zolpidem for sleep, and therefore, were included in this study. These subjects were then matched for age, gender, percentage of total body surface area (TBSA) burn, extent (percentage) of third-degree burn, inhalation injury, and ventilator status to patients without a pre-burn diagnosis of ADHD.
Length of time on zolpidem and any changes in medication or dosing were analyzed within and between the two groups to determine the effectiveness of the medication. Tolerance has been reported when zolpidem is taken for two weeks or longer (NLM NIH, n.d.). Therefore, for the purpose of this study, effectiveness was defined as no need for a change in the sleep medication regimen during the first 12 days of treatment.
Comparisons between the paired patients with and without a history of ADHD were made by paired t-test and McNemar's test. Data were analyzed using Statistical Analysis Software version 9.1.3 (Raleigh, NC).
Methods
A retrospective chart review was conducted of all children with acute burn injuries with a length of stay greater than three days admitted to Shriners Hospitals for Children in Cincinnati, Ohio, between the years 2005 and 2011 (N = 320). A review of each patient's diagnostic coding, nursing admission history, psychiatric consultation, as well as physician's notes, was performed to identify all patients with a pre-burn diagnosis of ADHD. These charts were examined to isolate those patients initially placed on zolpidem for sleep disturbances. The medical records of 205 children admitted for burn care were identified as being coded for ADHD; however, only 23 of these patients were initially placed on zolpidem for sleep, and therefore, were included in this study. These subjects were then matched for age, gender, percentage of total body surface area (TBSA) burn, extent (percentage) of third-degree burn, inhalation injury, and ventilator status to patients without a pre-burn diagnosis of ADHD.
Length of time on zolpidem and any changes in medication or dosing were analyzed within and between the two groups to determine the effectiveness of the medication. Tolerance has been reported when zolpidem is taken for two weeks or longer (NLM NIH, n.d.). Therefore, for the purpose of this study, effectiveness was defined as no need for a change in the sleep medication regimen during the first 12 days of treatment.
Comparisons between the paired patients with and without a history of ADHD were made by paired t-test and McNemar's test. Data were analyzed using Statistical Analysis Software version 9.1.3 (Raleigh, NC).