From the FDA Drug Label
Patients usually do not remember these events. Postmarketing reports have shown that complex sleep behaviors may occur with zolpidem tartrate alone at recommended doses, with or without the concomitant use of alcohol or other Central Nervous System (CNS) depressants Abnormal thinking and behavior changes have been reported in patients treated with sedative/hypnotics, including zolpidem tartrate. Some of these changes included decreased inhibition (e.g., aggressiveness and extroversion that seemed out of character), bizarre behavior, agitation and depersonalization.
The FDA drug label does not answer the question.
From the Research
Benzodiazepines, particularly clonazepam, are the most effective treatment for sleepwalking, with a recommended starting dose of 0.5 mg taken 30 minutes before bedtime, which may be increased to 1-2 mg if needed, as supported by the most recent and highest quality study 1.
Key Considerations
- Sleepwalking is a non-REM sleep parasomnia, an arousal disorder, and treatment should focus on suppressing deep sleep (N3 stage) and enhancing inhibitory neurotransmission in the brain.
- Clonazepam is often effective in treating sleepwalking, but alternatives like diazepam or non-benzodiazepine medications such as zolpidem may be considered for those who cannot tolerate clonazepam.
- Treatment duration varies by individual, but often continues for 3-6 months before attempting to taper off to see if sleepwalking recurs.
- Ensuring safety by removing hazards from the home, securing doors and windows, and possibly using door alarms is crucial before starting medication.
- Addressing underlying triggers like sleep deprivation, stress, or other sleep disorders is also essential, as supported by studies 2, 3, 4.
Important Safety Information
- Medical supervision is essential as these medications can cause side effects including daytime drowsiness, dependence, and tolerance.
- Zolpidem, a non-benzodiazepine medication, has been associated with complex behaviors, increased suicidality, and other adverse effects, making it a less preferred option for sleepwalking treatment, as highlighted in the study 5.
Additional Treatment Options
- Scheduled waking and hypnosis may be suggested for sleepwalking that results in distress or violence towards others, as mentioned in the study 3.
- Treatment of underlying sleep disorders, such as sleep-disordered breathing, may also be effective in controlling sleepwalking, as demonstrated in the study 4.