For instance, narcolepsy has been estimated in one study at 25 to 00 when cataplexy is required and higher at 00 when cataplexy is not required ( 9). However, these population estimates vary. Population studies have revealed that sleep disorders are affecting many more people worldwide than previously understood. In Alberta, Canada, the prevalence of sleep disorders, in particular OSA, is increasing mainly due to the aging population and rising rates of chronic obstructive pulmonary disease and obesity ( 8). Recently the possible relationship between vaccinations and narcolepsy has been explored, with a recent reported increase in narcolepsy cases in Europe associated with large-scale population immunization campaigns such as the adjuvanted 2009 influenza A (H1N1) pandemic vaccines ( 7). Other sleep disorders such as insomnia have a high co-occurrence with psychiatric disorders ( 6). Specifically, OSA has been associated with hypertension, heart failure, ischemic heart disease, arrhythmias, metabolic syndrome, pulmonary hypertension, stroke, and depression ( 5). People with daytime sleepiness have a tendency to fall asleep in inappropriate places at inappropriate times, and have poor concentration which impacts daily functioning, work productivity and can even cause motor-vehicle accidents ( 4). Sleep disorders can both be affected by disease and impact disease, with sleep deprivation and associated disorders having been shown to have large impacts on health ( 3). Despite the prevalence of sleep disorders, methodologies used for identifying such patients from administrative data are limited. The International Classification of Sleep Disorders 3rd Edition (ICSD-3)( 2) has identified over 80 different types of sleep disorders, the most common of which include obstructive sleep apnea (OSA), insomnia and narcolepsy. It has been reported that 35 to 40% of the US adult population annually are affected by problems falling asleep or daytime sleepiness ( 1). Published by Elsevier B.V.Sleep disorders are common however, prevalence estimates of different sleep disorders vary. Hypnotic drugs Insomnia disorder Non-rapid eye movement sleep Rapid eye movement sleep Sleep Zolpidem.Ĭopyright © 2016. With their array of therapeutic uses and their popularity among physicians and patients this review describes the clinical pharmacology, indications and uses, identifying withdrawal symptoms, abuse and dependence potentials, and adverse drug reactions are discussed. Sublingual zolpidem-LD (5mg) and zolpidem oral spray are indicated for middle-of-the-night (MOTN) wakefulness and difficulty returning to sleep, while sublingual zolpidem-SD (10mg) is marketed for difficulty falling asleep. Zolpidem-ER at doses of 6.25mg and 12.5mg, improves sleep maintenance in elderly and non-elderly patients, respectively, 4h after its administration. Zolpidem-IR reduces sleep latency (SL) at recommended doses of 5mg and 10mg in elderly and non-elderly patients, respectively. Peak plasma concentration is somewhat shorter for the sublingual forms and the oral spray, while their t½ is comparable to that of zolpidem-IR. The extended-release formulation results in a higher concentration over a period of more than 6h. Peak plasma concentration (Tmax) of zolpidem-IR occurs in 45 to 60min, with the terminal elimination half-life (t½) equating to 2.4h. So far, Zolpidem has been studied in several clinical populations: cases poor sleepers, transient insomnia, elderly and non-elderly patients with chronic primary insomnia, and in comorbid insomnia. In addition to immediate-release (IR) and extended-release (ER) formulations, the new delivery forms including two sublingual tablets, and an oral spray form have been recently developed which bypass the gastrointestinal tract. Zolpidem is a short-acting non-benzodiazepine hypnotic drug that belongs to the imidazopyridine class.
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