Zolpidem Guidelines

Introduction to Zolpidem

The FDA recommends a starting dosage of zolpidem of 5 mg for women and either 5 or 10 mg for men, taken once daily immediately before bedtime, as stated by the American Academy of Sleep Medicine 1
Women clear zolpidem more slowly than men, hence the lower recommended starting dose, with 45% higher blood levels 1

Zolpidem reduces sleep onset latency by approximately 15-18 minutes, according to the American College of Physicians 2
Zolpidem increases total sleep time by approximately 23-29 minutes, as reported by the American College of Physicians 2, 1
Zolpidem reduces wake after sleep onset by approximately 25 minutes 1
Zolpidem improves overall sleep quality compared to placebo, with moderate improvement, as stated by the American Academy of Sleep Medicine 1

The American Academy of Sleep Medicine recommends using the lowest effective dose for the patient, with the option to increase the dose to 10 mg if the 5 mg dose is not effective, while considering the increased risk of next-day impairment 1
The American Geriatrics Society advises caution when using zolpidem in elderly patients due to increased risk of falls, confusion, and complex sleep behaviors, and suggests considering alternative medications like low-dose doxepin (3-6 mg) for elderly patients with sleep maintenance issues 1
The American Academy of Sleep Medicine suggests avoiding zolpidem and other Z-drugs in elderly patients due to increased risk of falls, confusion, and complex sleep behaviors 3

Zolpidem may cause adverse effects including amnesia, dizziness, somnolence, headache, nausea, and taste perversion, as reported by the American Academy of Sleep Medicine 1
Zolpidem may cause next-day impairment, especially with the 10 mg dose 1
There is an increased risk of falls, confusion, and complex sleep behaviors in elderly patients taking zolpidem 3, 1
For elderly patients with insomnia, low-dose doxepin (3-6 mg) may be a safer alternative for sleep maintenance issues 3