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Insomnia is defining as a problem in sleep onset or maintaining sleep or frequent awakenings during the night.
It’s an irritating medical condition that leads to activities impairment, loss of occupational productivity, and maybe results in some physical harm like accidents or exacerbation of existing disease. As up to 40% of the population suffer from insomnia and experiencing daytime sleepiness.
Insomnia could be transient (less than 1 week) or short-term (less than 4 weeks) or chronic (more than 4 weeks), Every type of them should be evaluated and treated differently.
Good sleep hygiene must be tried before start drugs and be maintained during treatment these include:
- Stationary sleep and awakenings times.
- Don’t go to bed unless you are feeling asleep.
- Maintain 7 to 8 hours of sleep daily not more not less.
- Avoid any condition that could bother you (light, noise, bed comfortability).
- Don’t stay in bed for more than 20min if you are not able to go to sleep.
- Don’t go to bed hungry.
- Avoid any activities in the bedroom except for sleeping and sex.
- Avoid social media and any source of news before bedtime.
- Avoid naps during the day.
- Avoid drinking any source for stimulants like nicotine or caffeine.
- Exercise during the daytime will help you fall asleep easily.
The initial clinical trials and post marketing reporting stated that “Z-drugs.” have a promising profile of adverse effects and lower potential to addiction and abuse with efficacy equal to benzodiazepines.
Zaleplon shortens the onset of sleep but does not prolong sleep time or the number of awakenings. Zaleplon 10mg is indicated only for short-term treatment of insomnia. Zaleplon 10mg has been used in trials for up to 5 weeks.
Zaleplon use may be associated with early awakening, don’t use zaleplon twice in the same night.
For adults, the recommended dose is 10 mg. Do not increase the dose to 10mg whatever the situation, Keep the duration of treatment as short as possible, a maximum of two weeks.
Zaleplon should be taken immediately before going to bed (fast-acting). Take it on empty stomach with no heavy meals to avoid poor absorption.
For elderly patients, they may be sensitive to the effects of hypnotics; therefore, 5 mg is the recommended dose of zaleplon.
For Pediatric patients, zaleplon is contraindicated in children and adolescents under 18 years of age.
For patients with hepatic impairment, the clearance of zaleplon is reduced in those people, in mild to moderate hepatic impairment restrict to zaleplon 5 mg. For severe hepatic impairment avoid zaleplon use.
For patients with renal impairment, No dose adjustment is required in patients with mild to moderate renal insufficiency, for Severe renal impairment avoid zaleplon use.
You cannot use zaleplon in this situation:
- Myasthenia gravis.
- Severe renal or hepatic impairment
- Children and adolescents less than 18 years old.
- Severe respiratory disease.
- Severe sleep apnea.
- Hypersensitivity to zaleplon.
Zaleplon side effects
Z-drugs have a very narrow adverse reactions profile, most of the patients tolerate them well.
The Most common adverse reactions were: headache, gastrointestinal upset, and dizziness.
less common adverse effects include pruritus, visual disturbance, and xerostomia (dry mouth resulting from reduced or absent saliva flow).
The residuals effects remaining in the next days are a major concern with These drugs as it can disturb usual daily activities, zaleplon (for its short duration of action ) consider the least agent to cause this.
Everyone who will take zaleplon should be warned about the potential risk of engaging in complex behaviors while asleep. Such behaviors may include driving, eating, having sex, or talking on the telephone while asleep (with amnesia for the event).
These adverse reactions could be more aggressive with elderly patients, so reduced doses are recommended.
Avoid zaleplon and alcohol use at the same time as this increases the depressing effect on the central nervous system.
Tolerance, dependence, and withdrawal.
Tolerance, dependence, and withdrawal are all reported with Z-drugs, zaleplon 10mg is known for its low incidence and less severity of tolerance, withdrawal, and dependence in contrast with traditional benzodiazepines and other Z-drugs used to treat insomnia.
Withdrawal symptoms including rebound insomnia, delirium, craving, anxiety, tremor, palpitations, and rarely, seizures, and psychosis. This phenomenon has not been reported with therapeutic doses of Zaleplon 10mg.
Abuse potential exists for all Z-drugs, it is less commonly reported for zaleplon.
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