Short-term studies have suggested
that newer hypnotic agents,
such as zolpidem, produce less
rebound insomnia, compared with
benzodiazepines. Research reported
in European Neuropsychopharmacology
(August 2004), however,
showed that zolpidem is not
superior to the benzodiazepine temazepam
with respect to rebound
insomnia.
Rebound insomnia may occur
after patients stop taking certain
sleep medications. A randomized,
controlled trial compared the prevalence
of rebound insomnia in
zolpidem-and temazepam-treated
patients after they discontinued
treatment for chronic insomnia.
During the initial 4-week treatment
period, equivalent doses of
both agents were comparably safe
and efficacious in improving total
sleep time (TST) and sleep onset
latency (SOL). After cessation of
treatment, the prevalence of rebound
insomnia, which was defined
by a worsening of TST or SOL,
also was similar with both agents.
Therefore, it appears that at least
one of the newer "Z drugs," zolpidem,
has no advantages over
temazepam in clinical use for insomnia
or for rebound insomnia.