Therefore, standard doses may not be safely used in patients with MOTN insomnia. At lower doses, however, the residual daytime effects of Zolpidem may be reduced and it may thus be useful in MOTN insomnia. It should be noted, however, that at least one study suggested that the subjective sedating effects of Zolpidem persisted as long as five hours after dosing, a factor that may be important depending on time of administration and time of arising. Still, although standard five and ten milligram s doses may be associated with morning sedation if taken after midnight, lower doses of sublingual Zolpidem may be less likely to cause morning sedation and may thus be useful for treating short-term insomnia characterized by difficulty in initiating sleep and in MOTN insomnia. (7).
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Insomnia is a multifaceted clinical entity and can either be the specific condition of primary insomnia or be associated with one or more of a variety of medical or psychiatric disorders [38]. Comorbidities that exist with insomnia are often bidirectional; not only does insomnia increase the odds of developing psychiatric and medical problems, but the latter two also increase the likelihood of insomnia. (8) Zolpidem among the two drugs approved by the US Food and Drug Administation, Zolpidem has shown more efficacy in patients suffering from chronic comorbid insomnia. (9) Studies conducted by researcher of depression in adolescents, Asnis GM, suggest clear benefits of zolpidem in comorbid insomnia. Researcher Asnis and his team evaluated Zolpidem in one hundred and ninety patients treated with either fluoxetine, sertraline, or paroxetine for a depressive disorder for four weeks (10). After one week, single-blind placebo period, the patients received either placebo or ten milligrams of zolpidem nightly for four weeks. The Zolpidem treated cohorts showed longer sleep times, better sleep quality and reduced "wake after sleep onset " which lasted through first to fourth week among the three effects.