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J Clin Sleep Med. 2018 Nov 15;14(11):1949-1952. doi: 10.5664/jcsm.7500.

Polysomnographic Sleep Disturbances Due to High-Dose Zolpidem Use: A Case Report.

Author information

1
Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan.

Abstract

Zolpidem is widely prescribed for the treatment of insomnia and is used to both induce and maintain sleep. Previously, zolpidem was thought to have low abuse potential; however, several reports have documented dose escalation and abuse in the past two decades. Here, we report the case of a patient with high-dose zolpidem dependence who underwent polysomnography (PSG) and the Multiple Sleep Latency Test (MSLT). The patient, a 29-year-old man, was administered zolpidem at doses of 300 to 1,200 mg/day, but he abused zolpidem to feel energetic. Consequently, he had a car accident while on a high dose, which the PSG revealed caused activation instead of sedation. The MSLT showed excessive daytime sleepiness despite a lack of subjective sleepiness under this condition. Our findings suggest that disrupted sleep and daytime sleepiness caused by supratherapeutic zolpidem doses could place individuals at high risk for accidents, including those who are unaware of sleepiness.

KEYWORDS:

abused; polysomnography; zolpidem

PMID:
30373692
PMCID:
PMC6223559
[Available on 2019-05-15]
DOI:
10.5664/jcsm.7500

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