Sleep Disturbance and HMG CoA Reductase Inhibitors

To the Editor.— The National Cholesterol Education Program's treatment guidelines 1 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. 3 Schaefer4 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