Muscat  – A clinical trial led by an Omani psychiatrist is examining whether a commonly used muscle relaxant could offer a safe and effective alternative to standard insomnia medication.

Dr Tamadar Al Mahrouqi, psychiatrist at Sultan Qaboos University Hospital (SQUH) at University Medical City, is leading a double-blind randomised controlled trial comparing tizanidine with zolpidem in adults diagnosed with insomnia.

Responding to questions from Muscat Daily, Dr Tamadar said insomnia is often underestimated despite its wide-ranging impact. “Insomnia significantly affects daily functioning, emotional well-being and productivity. It is frequently dismissed as temporary, but chronic sleep disturbance can increase the risk of anxiety, depression and accidents, and may worsen existing medical conditions,” she said.

The study includes participants aged 18 to 65 who meet clinical criteria for insomnia. Recruitment is taking place through behavioural medicine clinics at SQUH and Al Masarra Hospital.

Sleep outcomes are being assessed using validated international tools, including the Pittsburgh Sleep Quality Index, Insomnia Severity Index and Clinical Global Impression scale, alongside objective measurements through polysomnography.

Dr Tamadar said the research was initiated to explore cost-effective treatments with lower dependency risks. “Zolpidem is widely prescribed and effective, but it carries concerns related to tolerance, dependence and next-day sedation,” she said. “Tizanidine is primarily used as a muscle relaxant, but its sedative properties may help patients who struggle to settle at night due to physical tension.”

She added that the trial differs from many regional studies by directly evaluating treatment outcomes in a controlled clinical setting. “We are combining subjective assessments with objective sleep measurements. This strengthens the clinical relevance of the findings,” she said.

Preliminary interim results indicate positive trends. “Participants receiving tizanidine have shown faster and, in some measures, greater improvements in sleep quality,” Dr Tamadar said. “Both groups demonstrated reduced insomnia severity, but earlier progress was observed in the tizanidine group. We have also noted fewer side effects and better tolerability so far.”

However, she cautioned against drawing firm conclusions at this stage. “These findings are preliminary. The sample size remains limited, and final conclusions will depend on comprehensive analysis once the study is complete.”

Recruitment has posed challenges, partly due to limited public awareness. “Many people normalise sleep difficulties and delay seeking medical advice. Others are hesitant about participating in clinical trials due to misconceptions,” she said. “We ensure strict safety protocols, close monitoring and continuous medical support for all participants.”

The study is funded by the Ministry of Higher Education, Research and Innovation and conducted in collaboration with Sultan Qaboos University, SQUH and the Ministry of Health.

If the results are confirmed, Dr Tamadar said the findings could broaden treatment options. “This may provide clinicians with an additional therapy, particularly for patients who do not respond well to existing medications or require options with lower dependency risks,” she said. “It could also inform national clinical guidelines and support further investment in sleep medicine research in Oman.”