Single—dose subcutaneous administration of flunitrazepam for insomnia in patients with advanced cancer

ABSTRACT

Insomnia in advanced cancer patients has a highly negative impact on the patients, their families and caregivers. Insomnia is principally managed by pharmacological therapy； however, most advanced cancer patients are unable to receive oral medications. This prospective audit study investigated the efficacy of single—dose subcutaneous administration of flunitrazepam for treating insomnia in patients with advanced cancer. Sleep evaluation was conducted using the St. Mary’s Hospital Sleep Questionnaire. The primary endpoint was the quality of sleep； the secondary endpoints comprised other subscales of total sleep time, sleep latency and adverse effects. We enrolled 30 patients. The average dose of flunitrazepam dose was 0.9(0.1)mg. The good response rate for the quality of sleep was 90％. The total sleep time and sleep latency were 7.5(3.2)h and 31(9.1)min, respectively. Two patients were newly diagnosed with delirium during the study. The mean respiratory rate decreased(15/min before treatment to 14/min after treatment, P＝0.01) without any critical events. Single—dose subcutaneous administration of flunitrazepam may be potentially efficacious and simple in treating insomnia in advanced cancer patients.