A Z-drug for short-term insomnia
Zolpidem
A 'Z-drug' used for the short-term treatment of insomnia, helping people fall asleep when poor sleep is causing real problems.
What is Zolpidem?
Zolpidem is a 'Z-drug' used for the short-term treatment of insomnia. It helps you fall asleep and is taken just before bed when you can get a full night's rest. It is meant for brief use only, because dependence can develop, and it can cause next-day drowsiness and, rarely, complex sleep behaviours.
Education and reference only. This is a plain-language guide to Zolpidem — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Zolpidem is a 'Z-drug', a group of sleeping tablets that are not benzodiazepines but act in a similar way. In the UK it is licensed for the short-term treatment of insomnia that is severe, disabling or causing marked distress. Like benzodiazepines it is intended for short courses rather than nightly long-term use, because dependence can develop and sleep problems are usually better managed with good sleep habits and, where needed, talking therapy.
How it works
Zolpidem acts on the same GABA system as benzodiazepines, strengthening the brain's main calming signal but in a way that is more focused on promoting sleep than on general sedation or muscle relaxation. This helps people fall asleep more easily. Because it still calms the nervous system, it can cause drowsiness and must not be combined with alcohol or other sedatives.
What it treats
Conditions Zolpidem is used for
Practical use
How to take Zolpidem
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it just before getting into bed, when you can get a full night's sleep ahead.
- Use it only for the short course your prescriber recommends.
- Do not take it if you may need to get up and function within a few hours.
- Avoid alcohol while taking it.
- Do not drive or use machinery if you feel drowsy, including the next day.
- Stop and seek advice if you are told you have walked, driven or eaten while asleep.
Weighing it up
Advantages & disadvantages of Zolpidem
Advantages
- Helps people fall asleep during a short, difficult period.
- Focused on promoting sleep rather than broad sedation.
- Well-established option for short-term insomnia.
Disadvantages
- Risk of dependence, so it is for short-term use only.
- Can cause next-day drowsiness and impaired driving.
- Rarely causes complex sleep behaviours such as sleep-walking or sleep-driving.
- Must not be combined with alcohol or other sedating medicines.
- Does not treat the underlying causes of poor sleep.
Practical use
Good to know
Zolpidem is taken just before bed, only when you can devote a full night to sleep, because taking it without enough sleep time ahead can leave you drowsy and impaired the next day. It is for short-term use only, as dependence can develop. Rarely it can cause complex sleep behaviours such as sleep-walking, driving or eating while not fully awake, with no memory of it afterwards; if this happens it should be stopped and reported. Do not drive if you feel drowsy, and avoid alcohol.
Who should not take it / use with caution
- People with a known allergy to zolpidem.
- People with severe breathing problems, severe sleep apnoea or significant liver problems.
- People with myasthenia gravis.
- Use with caution in older people, who are more prone to drowsiness and falls, and in those with a history of dependence.
Monitoring
- Review of whether it is still needed, to keep courses short.
- Watching for next-day impairment and any complex sleep behaviours.
- Particular care in older people because of falls.
Side effects
- Next-day drowsiness, tiredness and slowed reactions.
- Dizziness, unsteadiness and risk of falls.
- Headache or a hungover feeling.
- Rarely, complex sleep behaviours (sleep-walking, sleep-driving or sleep-eating) with no memory of them.
- Dependence with regular or prolonged use.
Key interactions
- Alcohol, which increases sedation and the risk of complex sleep behaviours.
- Opioid painkillers, which combined with sedatives can dangerously slow breathing.
- Other sedating medicines, including some antidepressants and antihistamines.
- Tell your pharmacist or prescriber about all medicines you take.
Available as: Tablets.
Answers
Zolpidem: frequently asked questions
What is a Z-drug?
Z-drugs are sleeping tablets, including zolpidem, that are not benzodiazepines but work on the same calming (GABA) system in the brain. They are used for short-term treatment of insomnia.
When should I take zolpidem?
Take it just before getting into bed, only when you can get a full night's sleep. Taking it without enough sleep time ahead can leave you drowsy and impaired the next day.
Can zolpidem make me do things in my sleep?
Rarely, yes. Some people have walked, driven, eaten or done other activities while not fully awake, with no memory afterwards. If this happens, stop it and tell your prescriber, and avoid alcohol, which raises the risk.
Is zolpidem addictive?
Dependence can develop, which is why it is prescribed only for short courses. Your prescriber will advise on the shortest helpful course and how to stop.
What is the difference between zolpidem and Stilnoct?
They are the same medicine. Zolpidem is the active-ingredient (generic) name and Stilnoct is a brand name; both contain identical zolpidem.
The wider class
About Benzodiazepines & Z-drugs
Zolpidem belongs to the benzodiazepines & z-drugs class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF: Zolpidem.
- NICE CKS: Zolpidem.
- electronic Medicines Compendium (SmPC): Zolpidem.
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