J Korean Soc Biol Ther Psychiatry.  2021 Jun;27(2):89-96.

Zolpidem-Induced Complex Sleep-Related Behavior

  • 1Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
  • 2Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea


Zolpidem is a non-benzodiazepine hypnotic agent as an agonist of the GABA A benzodiazepine receptor. Zolpidem is considered to have lower abuse and dependence potential than benzodiazepines, and is widely used for the shortterm treatment of insomnia. However, the complex sleep-related behaviors caused by zolpidem have recently emerged as a major challenge. The purpose of this study was to review zolpidem-induced complex sleep-related behaviors and one of the most commonly reported behaviors, sleep-related eating disorder. The risk factors for these complex sleep-related behaviors are female sex, advanced age, daily doses of 10 mg or more, alcohol consumption, and comorbid medical illnesses. Strategies for managing zolpidem-induced complex sleep-related behaviors; discontinuing the use of zolpidem, switching to different sedative-hypnotic drugs, treating patients with other classes of medications, and using non-pharmacological treatment strategies for patients with sleep disorder. These strategies should also include examining drug regimens for potential drug interactions that may predispose patients to experiencing complex behaviors, administering zolpidem appropriately, and selecting patients more carefully for treatment in terms of their likelihood of experiencing medication-related adverse reactions. In conclusion, complex sleep-related behaviors related to zolpidem should be considered adverse drug reactions prior to drug prescription, and a patient’s potential risk factors should be evaluated. Physicians should pay attention to the occurrence of abnormal behavioral adverse effects related to zolpidem.


Zolpidem; Insomnia; Adverse drug reaction; Amnesia; Eating behavior
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