Low Dose Zolpidem (Ambien) for Middle of the Night Awakening

Staying asleep and getting back to sleep after awakening are major issues for seniors.   In the past, physicians were counseled not to use drugs like Zolpidem (Ambien) unless a user had a good 7- 8 hours after taking the drug to remain in bed and rest while the product is metabolized and leaves their body.  The drug is relatively long acting and has been associated with sleep walking, day time sleepiness, falling and motor vehicle accidents especially when the user takes them in the middle of the night and awakens early for activities. Seniors are particularly prone to night time awakening for toileting activities, aches and pains and other issues.

The FDA has just approved a low dose version of Zolpidem for those patients who awaken in the middle of the night and cannot get back to sleep.  It is manufactured under the brand name Intermezzo in doses of 1.75 mg for women and 3.5 mg for men. The difference in dosing is based on the difference in the speed at which men and women metabolize the drug.

I am advising my patients to please be patient and allow us to evaluate how this product performs in large numbers of human subjects. The original studies were performed on 375 patients. It will be interesting to see if this product will be appropriate for overnight airplane travelers on four and five hour plane flights as well.