From the Guidelines
Zolpidem is effective in treating insomnia by reducing sleep onset latency and increasing total sleep time, with a recommended dosage of 5-10 mg taken once daily immediately before bedtime, as supported by moderate-strength evidence from studies such as 1 and 1. The medication works by binding to GABA-A receptors in the brain, specifically targeting the alpha-1 subunit which is responsible for sedation. Some key points to consider when using zolpidem for insomnia include:
- The typical dosage is 5-10 mg taken once daily immediately before bedtime, with the lower dose often recommended for elderly patients or those with liver problems.
- Zolpidem is intended for short-term use (usually 7-10 days) as longer use can lead to tolerance and dependence.
- The medication should be taken only when you have 7-8 hours available for sleep to avoid next-day impairment.
- Side effects may include dizziness, headache, drowsiness, and rarely, complex sleep behaviors like sleepwalking.
- It's essential to avoid alcohol while taking zolpidem as this can increase the risk of dangerous side effects.
- This medication works best when combined with good sleep hygiene practices such as maintaining a regular sleep schedule and creating a comfortable sleep environment, as noted in studies like 1 and 1. Overall, zolpidem can be a useful treatment option for insomnia, but it's crucial to use it judiciously and under the guidance of a healthcare professional, considering the potential risks and benefits, as highlighted in studies such as 1 and 1.
From the FDA Drug Label
Zolpidem tartrate tablets are indicated for the short-term treatment of insomnia characterized by difficulties with sleep initiation. Zolpidem was evaluated in two controlled studies for the treatment of patients with chronic insomnia Zolpidem tartrate tablets have been shown to decrease sleep latency for up to 35 days in controlled clinical studies
Tab Zolsoma (Zolpidem) helps in insomnia by:
- Decreasing sleep latency
- Improving sleep duration and sleep quality
- Reducing the number of awakenings Zolpidem works by binding to the benzodiazepine site of α1 subunit containing GABA A receptors, increasing the frequency of chloride channel opening resulting in the inhibition of neuronal excitation 2, 2.
From the Research
Mechanism of Action
- Zolpidem, also known as tab zolsoma, is a non-benzodiazepine hypnotic that helps in the treatment of insomnia by decreasing sleep latency and increasing total sleep time and sleep efficiency without affecting sleep architecture 3.
- It exhibits high-affinity binding at a benzodiazepine-receptor subtype that is located in the cerebellum and cerebral cortex but not in the spinal cord or peripheral tissues 3.
Efficacy in Insomnia
- Zolpidem has been shown to be effective in increasing sleep time and decreasing sleep latency, with efficacy equal to that of benzodiazepines without causing rebound insomnia or withdrawal effects 3.
- Comparative trials have found zolpidem as effective as flunitrazepam, flurazepam, and triazolam in the treatment of insomnia 3.
- The optimum dose of zolpidem tartrate is 10 mg at bedtime; 5 mg for elderly patients 3.
Safety and Side Effects
- Adverse reactions to zolpidem are dose-related and have primarily CNS and gastro-intestinal manifestations 3.
- Zolpidem has been associated with an increased risk of falls in hospitalized patients, hip fractures, and complex sleep-related behaviors such as sleepwalking and driving cars while asleep 4, 5.
- The use of zolpidem is also associated with rebound insomnia, next-day residual effects on driving ability, memory, and psychomotor performance 5.
Comparison with Other Treatments
- Zolpidem is considered a reasonable choice of therapy for insomnia because it has a lower incidence of residual daytime sleepiness and risk of falls when compared to other drugs 4.
- Other treatments for insomnia, such as suvorexant and low-dose doxepin, may also be effective for sleep maintenance insomnia, while ramelteon may be recommended for sleep onset insomnia 6.