Rebound Insomnia: Some Medications Are Created Equal

Short-term studies have suggestedthat newer hypnotic agents,such as zolpidem, produce lessrebound insomnia, compared withbenzodiazepines. Research reportedin European Neuropsychopharmacology(August 2004), however,showed that zolpidem is notsuperior to the benzodiazepine temazepamwith respect to reboundinsomnia.

Rebound insomnia may occurafter patients stop taking certainsleep medications. A randomized,controlled trial compared the prevalenceof rebound insomnia inzolpidem-and temazepam-treatedpatients after they discontinuedtreatment for chronic insomnia.

During the initial 4-week treatmentperiod, equivalent doses ofboth agents were comparably safeand efficacious in improving totalsleep time (TST) and sleep onsetlatency (SOL). After cessation oftreatment, the prevalence of reboundinsomnia, which was definedby a worsening of TST or SOL,also was similar with both agents.Therefore, it appears that at leastone of the newer "Z drugs," zolpidem,has no advantages overtemazepam in clinical use for insomniaor for rebound insomnia.