Background:

Being a nonbenzodiazepine, zolpidem is believed to have a favorable side-effect profile and is widely prescribed for insomnia. However, in the past few years, numerous neuropsychiatric adverse reactions, particularly complex sleep behaviors (CSBs), have been reported with zolpidem.

Objective:

To conduct a systematic review of zolpidem-associated CSBs.

Data Sources:

An electronic search was conducted using MEDLINE, Embase, PubMed, and Cochrane database of systematic reviews to extract relevant articles till July 2020.

Study Eligibility Criteria:

Any type of literature article (case report, case series, and observational or interventional study) reporting CSBs associated with zolpidem.

Results:

In this review, we present aggregate summarized data from 148 patients presenting with zolpidem-induced CSBs (79 patients from 23 case reports and 5 case series; 69 patients out of 1454 taking zolpidem [4.7%] from three observational clinical studies). Various types of CSBs associated with zolpidem were reported, most common being sleepwalking/somnambulism and sleep-related eating disorder. On causality assessment, around 88% of cases were found to have a probable association with zolpidem.

Limitations:

Extraction of data from observational studies and spontaneous reports, due to nonavailability of any randomized controlled trials relevant to the study objective.

Conclusion and Implication of Key Findings:

Zolpidem-induced CSBs, although not very common, may develop when the drug is used at therapeutic doses for insomnia. Doctors need to be alert to monitor such adverse effects of zolpidem and exercise caution while prescribing it.

中文翻译：

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唑吡坦失眠症：一把双刃剑。唑吡坦诱导的复杂睡眠行为的系统文献综述

背景：

作为一种非苯二氮卓类药物，唑吡坦被认为具有良好的副作用，并被广泛用于治疗失眠症。然而，在过去几年中，唑吡坦报告了许多神经精神不良反应，特别是复杂的睡眠行为 (CSB)。

客观的：

对唑吡坦相关的 CSB 进行系统评价。

数据源：

使用 MEDLINE、Embase、PubMed 和 Cochrane 系统评价数据库进行电子搜索，以提取截至 2020 年 7 月的相关文章。

学习资格标准：

报告与唑吡坦相关的 CSB 的任何类型的文献文章（病例报告、病例系列和观察性或干预性研究）。

结果：

在这篇综述中，我们提供了来自 148 名出现唑吡坦诱导的 CSB 患者的汇总汇总数据（来自 23 个病例报告和 5 个病例系列的 79 名患者；来自三项观察性临床研究的 1454 名患者中有 69 名服用唑吡坦 [4.7%]）。报告了与唑吡坦相关的各种类型的 CSB，最常见的是梦游/梦游和睡眠相关的进食障碍。在因果关系评估中，发现约 88% 的病例可能与唑吡坦有关。

限制：

由于没有与研究目标相关的任何随机对照试验，从观察性研究和自发报告中提取数据。

主要发现的结论和含义：

唑吡坦诱导的 CSBs 虽然不是很常见，但在以治疗剂量使用治疗失眠症时可能会出现。医生需要警惕监测唑吡坦的此类不良反应，并在开药时谨慎行事。