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September 5, 1990

Sleep Disturbance and HMG CoA Reductase Inhibitors

JAMA. 1990;264(9):1105. doi:10.1001/jama.1990.03450090041020

To the Editor.—  The National Cholesterol Education Program's treatment guidelines1 have led to a substantial increase in the treatment of hypercholesterolemia. Lovastatin (Mevacor) was approved by the Food and Drug Administration in 1987 and is now the most frequently prescribed hypolipidemic agent.2 The recognized adverse effects of lovastatin have been mainly confined to reversible liver transaminase elevations and, rarely, myopathy.3Schaefer4 reported that nine (17.6%) of 51 patients taking lovastatin by prescription had decreased sleep of 1 to 3 hours, compared with none of 33 patients receiving another 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitor, pravastatin, in a clinical trial.

Study.—  We have assessed the prevalence of sleep disorders more systematically, using a standard questionnaire, in 409 hyperlipidemic patients (67% male) being treated by diet alone (n=102), receiving three different types of HMG CoA reductase inhibitor (lovastatin [n = 161], simvastatin [n = 47], and pravastatin [n = 45]), or