Recommended Dosage of Temazepam (Restoril) for Insomnia
The recommended dose of temazepam for treating insomnia is 15 mg before bedtime for most adults, with 7.5 mg being sufficient for some patients and others potentially requiring 30 mg. 1
Dosing Guidelines by Patient Population
- Standard adult dose: 15 mg before bedtime 1
- Elderly or debilitated patients: Start with 7.5 mg until individual responses are determined 1
- Transient insomnia: 7.5 mg may be sufficient to improve sleep 1, 2
Efficacy by Dose
Temazepam has demonstrated effectiveness for sleep maintenance insomnia at the 15 mg dose:
- Improves total sleep time by approximately 99 minutes compared to placebo 3
- Provides small improvement in sleep quality 3
Dose-Response Relationship:
- 7.5 mg: Demonstrated hypnotic effects in transient insomnia, improving sleep efficiency and total sleep time 2
- 15 mg: Recommended standard dose with established efficacy for sleep maintenance 3, 4
- 30 mg: May be needed for some patients, but higher risk of side effects 1
Clinical Considerations
Indications
- Temazepam is specifically indicated for sleep maintenance insomnia rather than sleep onset issues 3, 4
- The medication may not effectively reduce sleep latency when taken at bedtime due to its pharmacokinetic profile 5
Administration
- Take 30 minutes before bedtime 2
- Peak plasma concentrations typically occur within 2-3 hours after ingestion 5
- Mean elimination half-life is 10-15 hours 5
Discontinuation
- Use a gradual taper to discontinue temazepam or reduce dosage 1
- If withdrawal reactions develop, consider pausing the taper or temporarily increasing to the previous dosage level 1
Cautions and Side Effects
- Common side effects include drowsiness, dizziness, and lethargy 6
- Incidence of adverse effects is generally low (7-8%) and typically mild 7
- Severity of adverse events tends to decrease over the course of treatment 7
Special Considerations
- Combining temazepam with cognitive-behavioral therapy (CBT) may allow for lower medication doses with comparable efficacy and fewer side effects 7
- Long-term use of hypnotic medications is not recommended due to limited evidence for safety and efficacy 4
- Short-term or intermittent use is preferred to minimize risks 8
Common Pitfalls to Avoid
- Dosing errors: Starting with too high a dose in elderly patients can lead to excessive sedation
- Inappropriate indication: Temazepam is more effective for sleep maintenance than sleep onset problems 3, 5
- Abrupt discontinuation: Can lead to withdrawal symptoms; always taper gradually 1
- Extended use: Limit to short-term treatment when possible 4