Sleep Medication Guidelines Tightened as Dependence Concerns Rise
SรO PAULO – Health experts are reinforcing guidelines for zolpidem use, a commonly prescribed sleep aid, amid growing concerns over patient dependence and possibly hazardous side effects including sleepwalking and amnesia. While effective for short-term insomnia, prolonged use of the medication – often exceeding the recommended four-week period – is proving problematic, specialists say.
Zolpidem, frequently enough referred to as a “Z drug,” remains a viable option for acute insomnia, defined as difficulty sleeping triggered by temporary tension or nervousness. However, many patients presenting for medical help suffer from chronic insomnia – experiencing sleep difficulties for more than three months – a condition for which zolpidem is not ideally suited.
“but this is rarely respected,” laments Dr. Meil, a specialist consulted on the issue. “When prescribing, we need to be careful not to allow the patient to use it for long periods.”
Reports surfacing online detail patients who claim dependence on the medication to sleep, and concerning incidents of individuals engaging in activities while under the drug’s influence without conscious recollection. These actions have, in certain specific cases, included illegal behavior and physical injury. The medication’s potential to induce amnesiac behavior is a key factor in these risks.
Experts now emphasize cognitive behavioral therapy (CBT) as the first-line treatment for insomnia. CBT has proven effective not only in treating insomnia but also in helping patients discontinue “Z drug” use. Follow-up is typically brief, with important improvements often observed after six to ten sessions, according to Dr. Mei.
Alongside therapy, adopting good “sleep hygiene” is crucial. Recommended practices include:
* Reducing light exposure, especially from artificial sources.
* Maintaining consistent sleep and wake times.
* Creating a calm and comfortable sleep surroundings.
* Avoiding electronic devices before bed.
* Limiting intense physical activity and heavy meals at night.
* Managing worries by writing down tasks for the following day.
* Reducing alcohol and caffeine intake in the evening.
* Avoiding work or television in bed.
* Establishing relaxing bedtime rituals like meditation or reading.