SummaryZolpidem, zopiclone and zaleplon are hypnotics with similar pharmacology to benzodiazepines. In addition to the usual adverse effects of sedative drugs, there have been unusual reactions associated with the 'z-drugs', particularly zolpidem. It is unclear why there have been so many reports of bizarre behaviour in Australians taking zolpidem. Some of the cases may be the result of other conditions or drugs. As many patients with insomnia can be managed without drugs, limiting the use of hypnotics will limit any harmful effects.
Sleep disorders are very common. Prevalence estimates vary widely because of variable case definitions, but roughly 25% of adults have insomnia, 20% have troublesome snoring, and 3% have obstructive sleep apnoea syndrome (OSAS) – repetitive apnoea during sleep and daytime sleepiness. That is a lot of people: insomnia is about as common as hypertension, and sleep apnoea is about as common as diabetes mellitus.
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