April 29, 2016
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Sleep Disorder Medications (cont.)

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For what conditions are hypnotics used?

Hypnotics are used for the treatment of insomnia which is characterized by difficulties with falling asleep or maintaining sleep. Specific hypnotics such as Intermezzo (zolpidem tartrate) can be used for insomnia involving middle of the night waking followed by difficulty returning to sleep. (Some hypnotics may have other uses. For example, Ambien, Ambien CR (zolpidem) also is used for promoting improvement in motor symptoms associated with Parkinson's disease although this use is not FDA-approved.)

Are there differences among hypnotics?

There are a variety of hypnotics that are used for treating insomnia. The main difference among the various hypnotics is their half-life, that is, how long the drug is active in the body.

  • The half-life determines the type and duration of hypnotic effects and the unwanted side effects.
  • When hypnotic drugs have long half-lives, the drug itself or the chemicals that the body makes from the drug tend to accumulate with nightly use, and the accumulation can cause impairment of normal day-time functions involving thought and motor skills.

There also is a larger risk of interactions with other drugs due to a carry-over effect of the hypnotic drug. In contrast, when hypnotic drugs with short half-lives are taken, the drugs are cleared from the body before the next dose is ingested or other drugs are taken, hence the carry-over effects are minimal or absent and do not affect thought and motor skills.

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