What is the use of Ambien (zolpidem)?

From the Guidelines

Ambien, also known by its generic name zolpidem, is a prescription medication that can be used for the short-term treatment of insomnia, specifically for sleep onset and sleep maintenance insomnia, as suggested by clinicians according to the American Academy of Sleep Medicine clinical practice guideline 1. The typical starting dose is 5mg for women and older adults or 5-10mg for men, taken once daily immediately before bedtime, as recommended in the clinical guideline for the evaluation and management of chronic insomnia in adults 2. It should only be used for short periods (usually 7-10 days) as it can cause dependence with longer use. Ambien works by enhancing the effect of GABA, a neurotransmitter that inhibits brain activity, helping to induce sleep. Some key points to consider when using Ambien include:

• Taking it only when 7-8 hours are available for sleep
• Avoiding alcohol while using it
• Not driving or operating machinery after taking it
• Using it with caution in patients with respiratory conditions, history of substance abuse, or certain mental health conditions
• Considering alternative treatments if insomnia persists beyond short-term use, as suggested by the clinical practice guideline 1. The FDA has also recommended that a warning be issued regarding adverse effects associated with BzRA hypnotics, such as sleepwalking, eating, driving, and sexual behavior, as noted in the clinical guideline for the evaluation and management of chronic insomnia in adults 2. Overall, the use of Ambien for the short-term treatment of insomnia should be carefully considered and monitored by a healthcare provider, taking into account the potential benefits and risks, as well as the individual patient's circumstances and medical history 1, 2.

From the FDA Drug Label

Zolpidem tartrate tablets are indicated for the short-term treatment of insomnia characterized by difficulties with sleep initiation. The answer to the question about Ambien, which is another name for zolpidem, is that it is used for the short-term treatment of insomnia.

• Key points about zolpidem include: + It is a sedative-hypnotic medicine + It should be taken right before bedtime and only if the patient can stay in bed for a full night (7 to 8 hours) + It may cause serious side effects, including complex sleep behaviors + The recommended dose is usually 5-10 mg for adults, taken once a night as needed [3] [4]
• Important warnings: + Do not take zolpidem with alcohol or other medicines that can make you sleepy + Do not take zolpidem if you have a history of complex sleep behaviors or allergic reactions to zolpidem + Zolpidem may cause dependence or abuse, so it should be kept in a safe place and only taken as directed by a healthcare provider 4

From the Research

Ambien (Zolpidem) Overview

• Ambien, also known as zolpidem, is a non-benzodiazepine hypnotic used to treat insomnia 5
• It has a wide variety of adverse effects, including an increased risk of falls, hip fractures, and complex behaviors such as sleepwalking and hallucinations 5
• Zolpidem has been associated with an increased risk of suicide attempts and completion, as well as seizures following withdrawal 5

Efficacy and Side Effects

• Zolpidem is effective in treating insomnia, but its use should be carefully considered due to its potential side effects 5
• Cognitive behavioral therapy for insomnia (CBT-I) is a recommended treatment for insomnia, and can be used in conjunction with zolpidem to minimize its side effects 5, 6
• CBT-I has been shown to improve quality of life and reduce symptoms of insomnia, and can be delivered in various formats, including face-to-face and online 6

Alternative Treatments

• Acute aerobic exercise has been shown to have similar effects on sleep as zolpidem in individuals with chronic insomnia 7
• CBT-I has been shown to improve cancer-related fatigue in cancer survivors with insomnia 8
• Therapist-guided digital CBT-I has been shown to be effective in improving sleep in individuals with mental health complaints, and can be adapted to meet individual needs 9

Special Considerations

• Zolpidem should be used with caution in elderly patients, as they may be more susceptible to its side effects 5
• Women may have higher plasma concentrations of zolpidem than men, and should be monitored closely for side effects 5
• Zolpidem is classified as a category C drug by the FDA, and its use during pregnancy should be carefully considered due to potential adverse outcomes 5