Zolpidem

Zolpidem is a Z-drug (non-benzodiazepine hypnotic) used for the short-term treatment of severe insomnia. It acts selectively on the alpha-1 subunit of the GABA-A receptor, providing hypnotic effects with less anxiolytic and muscle relaxant activity than benzodiazepines. Zolpidem has a short half-life (approximately 2.5 hours), making it suitable for sleep-onset insomnia. It should only be used when insomnia is severe and disabling.

How to Take Zolpidem

Take one tablet immediately before going to bed, on an empty stomach. Make sure you have at least seven to eight hours available for sleep before you need to be up and active. Do not take it with or just after a meal, as food delays absorption and slows the onset of effect.

Zolpidem is intended for short-term use only, typically two to four weeks. Using it for longer than this increases the risk of dependence and tolerance. Do not take more than the prescribed dose, and never combine it with alcohol, as the combination intensifies sedation and can suppress breathing during sleep.

5 mg to 10 mg immediately before bedtime. Start at 5 mg (particularly in elderly patients). Maximum: 10 mg daily. Treatment should not exceed four weeks including tapering.

Common Side Effects

Common side effects include:

• Drowsiness or a groggy feeling the next morning
• Headache
• Dizziness
• Diarrhoea
• Memory lapses

Serious Side Effects

Complex sleep behaviours have been reported with zolpidem, including sleepwalking, sleep-driving, preparing food, or making phone calls while not properly awake. These can be dangerous, and people usually have no memory of them happening. Stop taking zolpidem and speak to your doctor immediately if any of these behaviours occur.

Risk of dependence with prolonged use. Limit treatment to two to four weeks. Do not stop abruptly after regular use; taper gradually. Complex sleep behaviours have been reported; discontinue if they occur. Avoid alcohol.

Contraindicated in severe hepatic impairment, sleep apnoea syndrome, myasthenia gravis, severe respiratory insufficiency, and known hypersensitivity to zolpidem.