A comparison of complex sleep behaviors with two short-acting Z-hypnosedative drugs in nonpsychotic patients

Abstract

ObjectiveComplex sleep behaviors (CSBs) are classified as “parasomnias” in the International Classifcation of Sleep Disorders, Second Edition (ICSD-2). To realize the potential danger after taking two short-acting Z-hypnosedative drugs, we estimated the incidence of CSBs in nonpsychotic patients in Taiwan.MethodsSubjects (N = 1,220) using zolpidem or zopiclone were enrolled from the psychiatric outpatient clinics of a medical center in Taiwan over a 16-month period in 2006–2007. Subjects with zolpidem (N = 1,132) and subjects with zopiclone (N = 88) were analyzed. All subjects completed a questionnaire that included demographic data and complex sleep behaviors after taking hypnotics.ResultsAmong zolpidem and zopiclone users, 3.28% of patients reported incidents of somnambulism or amnesic sleep-related behavior problems. The incidence of CSBs with zolpidem and zopiclone were 3.27%, and 3.41%, respectively, which was signifcantly lower than other studies in Taiwan.ConclusionThese results serve as a reminder for clinicians to make inquiries regarding any unusual performance of parasomnic activities when prescribing zolpidem or zopiclone.

Zolpidem for Insomnia: A Double-Edged Sword. A Systematic Literature Review on Zolpidem-Induced Complex Sleep Behaviors

“…Of these, there were 23 case reports, 17 – 39 five case series, 40 – 44 and three observational studies. 45 – 47 …”

“…No significant association with older age or sex was observed; the incidence of CSBs was, in fact, higher in younger patients. 45 Hwang et al reported 28.3% incidence of CSBs with zolpidem (19/67 patients), with the more affected groups being younger patients, females, patients taking a higher dose of zolpidem, and patients not sleeping immediately after the drug intake. A higher dose of zolpidem (>10 mg/day) was concluded as a key risk predictor for CSBs.…”

Sleep Dysfunction and its Management in Parkinson’s Disease

“…Overall incidence is estimated at 3 % [46], and the drug should be stopped immediately if these occur. More common side effects include somnolence, headache, dizziness, and nausea.…”

Zolpidem overutilisation among Korean patients with insomnia

“…CSBs include sleep-walking, sleep-driving and sleep-eating. Recently, the FDA has issued a Blackbox Warning for zolpidem regarding this issue as some of these events could result in fatal injuries (Chen et al, 2013). Furthermore, zolpidem can also result in abuse or dependence.…”