Cited by 178Sleep and related disordersSleep and Work-Related FatigueTraffic and Road Safety

The DOI matches its Crossref record; 84 of the 85 references it cites were found in a registry or an index.

In the Zzz Zone: The Effects of Z-Drugs on Human Performance and Driving

Open access

Gunja, Naren·2013·Journal of Medical Toxicology

DOI 10.1007/s13181-013-0294-yPMC PMC3657033

Open this paper in CoChat — free account Open PDF

Abstract

Despite their improved pharmacokinetic profile, the Z-drugs, zolpidem, zopiclone, and zaleplon, have a spectrum of adverse effects comparable to benzodiazepines. This review focuses on the impairment from Z-drugs on cognition, behavior, psychomotor performance, and driving ability. Z-drugs are short-acting GABA agonists that reduce sleep latency without disturbing sleep architecture. Bizarre behavioral effects have prompted warnings on the prescription, dispensation, and use of Z-drugs. Psychomotor impairment, falls, and hip fractures are more likely to occur with Z-drugs that have longer half-lives, that are taken at higher-than-recommended doses and when mixed with other psychoactive substances including alcohol. Zopiclone and higher doses of zolpidem are more likely to cause anterograde amnesia than zaleplon. Z-drugs, especially zolpidem, are associated with complex behaviors such as sleepwalking, sleep-driving, and hallucinations. Patients taking zopiclone and zolpidem have an increased risk of motor vehicle collisions, over double that of unexposed drivers. Driving impairment occurs with zopiclone and higher doses of zolpidem but is unlikely to occur after 4 h post-zaleplon administration. The residual effect of Z-drugs on next-day cognitive and psychomotor performance has significant impact on lifestyle, safety, and occupational considerations, including motor vehicle and machine operation. The risk-benefit analysis of Z-drugs in the treatment of insomnia, particularly in the elderly, may not favor treatment due to the increased risks of falls and motor vehicle collisions. Prescribers should warn patients taking Z-drugs of minimum time thresholds before they operate machinery or drive motor vehicles.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1007/s13181-013-0294-y

Cites

84 of 84 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Aviat space environ med
(1992) · Applied Ergonomics · doi:10.1016/0003-6870(92)90318-p · Cited by 5,774
Meta-analysis of the Impact of 9 Medication Classes on Falls in Elderly Persons
Woolcott, J. C. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.357 · Cited by 1,326 · cited 1×
“The increased risk of psychomotor disturbance from benzodiazepine use has been well reported [40, 41], and the associated costs to the community have been estimated in billions of dollars [42].”
Background
Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits
Glass, J., Lanctôt, K. L., Herrmann, N., Sproule, B. A., & Busto, U. E. (2005) · BMJ · doi:10.1136/bmj.38623.768588.47 · Cited by 1,161
Association of road-traffic accidents with benzodiazepine use
Barbone, F., McMahon, A., Davey, P., Morris, A. D., Reid, I., McDevitt, D., & MacDonald, T. M. (1998) · The Lancet · doi:10.1016/s0140-6736(98)04087-2 · Cited by 555
Benzodiazepine Use and the Risk of Motor Vehicle Crash in the Elderly
Hemmelgarn, B. R. (1997) · JAMA · doi:10.1001/jama.1997.03550010041037 · Cited by 397
Risk of road accident associated with the use of drugs: A systematic review and meta-analysis of evidence from epidemiological studies
Elvik, R. (2012) · Accident Analysis & Prevention · doi:10.1016/j.aap.2012.06.017 · Cited by 340
Efficacy and safety of eszopiclone across 6-weeks of treatment for primary insomnia
Zammit, G. K., McNabb, L. J., Caron, J., Amato, D. A., & Roth, T. G. (2004) · Current Medical Research and Opinion · doi:10.1185/174234304x15174 · Cited by 294
Residual Effects of Hypnotics
Vermeeren, A. (2004) · CNS Drugs · doi:10.2165/00023210-200418050-00003 · Cited by 278
Zolpidem Use and Hip Fractures in Older People
Wang, P. S., Bohn, R. L., Glynn, R. J., Mogun, H., & Avorn, J. (2001) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2001.49280.x · Cited by 272
Comparative Pharmacokinetics and Pharmacodynamics of Short-Acting Hypnosedatives
Drover, D. R. (2004) · Clinical Pharmacokinetics · doi:10.2165/00003088-200443040-00002 · Cited by 248

Show all 85 references

Research works printed but not linked: 3

Therapeutic Goods Administration (2007) Zolpidem and bizarre sleep related effects. Aust Adverse Drug React Bull 26(1):2–3, http://www.tga.gov.au/pdf/aadrb-0702.pdf
Riedel WJ, Vermeeren A, Van Boxtel MPJ et al (1998) Mechanisms of drug-induced driving impairment: a dimensional approach. Hum Psychopharmacol Clin Exp 13(S2):S49–S63 · DOI
Weiss KJ, Del Busto E (2010) Sleep-driving and pathological intoxication: saved by the FDA? Am J Forensic Psychiatry 31(1):5–15

Sorted by citations

Drugs for Insomnia beyond Benzodiazepines: Pharmacology, Clinical Applications, and Discovery
Atkin, T., Comai, S., & Gobbi, G. (2018) · Pharmacological Reviews · doi:10.1124/pr.117.014381 · Cited by 400
Benzodiazepines and Z-drugs: an updated review of major adverse outcomes reported on in epidemiologic research
Brandt, J., & Leong, C. (2017) · Drugs in R&D · doi:10.1007/s40268-017-0207-7 · Cited by 356
Z-drugs and risk for falls and fractures in older adults—a systematic review and meta-analysis
Treves, N., Perlman, A., Geron, L. K., Asaly, A., & Matok, I. (2017) · Age and Ageing · doi:10.1093/ageing/afx167 · Cited by 187
Common Sleep Disorders Increase Risk of Motor Vehicle Crashes and Adverse Health Outcomes in Firefighters
Barger, L. K., Rajaratnam, S. M. W., Wang, W., O’Brien, C. S., Sullivan, J. P., Qadri, S., Lockley, S. W., Czeisler, C. A., & for the Harvard Work Hours, H. A. S. G. (2015) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4534 · Cited by 169
Relationship between the use of benzodiazepines and falls in older adults: a systematic review
Díaz-Gutiérrez, M. J., Martínez-Cengotitabengoa, M., Sáez de Adana, E., Cano, A. I., Martínez-Cengotitabengoa, M. T., Besga, A., Segarra, R., & González-Pinto, A. (2017) · Maturitas · doi:10.1016/j.maturitas.2017.04.002 · Cited by 131
The orexin story and orexin receptor antagonists for the treatment of insomnia
Muehlan, C., Roch, C., Vaillant, C., & Dingemanse, J. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13902 · Cited by 130
Orexin Receptor Antagonists: New Therapeutic Agents for the Treatment of Insomnia
Roecker, A. J., Cox, C. D., & Coleman, P. J. (2015) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.5b00832 · Cited by 115
Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review
Rudisill, T. M., Zhu, M., Kelley, G. A., Pilkerton, C. S., & Rudisill, B. R. (2016) · Accident Analysis & Prevention · doi:10.1016/j.aap.2016.08.001 · Cited by 107
Long-term use of benzodiazepines in chronic insomnia: a European perspective
Soyka, M., Wild, I., Caulet, B., Leontiou, C., Lugoboni, F., & Hajak, G. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1212028 · Cited by 108
Psychopharmacological Strategies in the Management of Posttraumatic Stress Disorder (PTSD): What Have We Learned?
Bernardy, N. C., & Friedman, M. J. (2015) · Current Psychiatry Reports · doi:10.1007/s11920-015-0564-2 · Cited by 93
Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the United States, 1999-2015
Xu, K. Y., Hartz, S. M., Borodovsky, J. T., Bierut, L. J., & Grucza, R. A. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.28557 · Cited by 87
Benzodiazepines and Related Drugs as a Risk Factor in Alzheimer's Disease Dementia
Ettcheto, M., Olloquequi, J., Sánchez‐López, E., Busquets, O., Cano, A. C., Manzine, P. R., Beas‐Zárate, C., Castro-Torres, R. D., García, M. L., Bulló, M., et al. (2020) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2019.00344 · Cited by 83
Nonclinical pharmacology of daridorexant: a new dual orexin receptor antagonist for the treatment of insomnia
Roch, C., Bergamini, G., Steiner, M. A., & Clozel, M. (2021) · Psychopharmacology · doi:10.1007/s00213-021-05954-0 · Cited by 83
Structural characterization and Hirshfeld surface analysis of a CoII complex with imidazo[1,2-a]pyridine
Seth, S. K. (2018) · Acta Crystallographica Section E Crystallographic Communications · doi:10.1107/s2056989018003857 · Cited by 69
Use of benzodiazepines and related drugs in Manitoba: a population-based study
Alessi‐Severini, S., Bolton, J. M., Enns, M. W., Dahl, M. E., Collins, D. M., Chateau, D. G., & Sareen, J. (2014) · CMAJ Open · doi:10.9778/cmajo.20130076 · Cited by 66
Orexin receptor antagonists as therapeutic agents for insomnia
Equihua-Benítez, A. C., la Herrán-Arita, A. K. D., & Drucker-Colín, R. (2013) · Frontiers in Pharmacology · doi:10.3389/fphar.2013.00163 · Cited by 67
Circuits and components of delta wave regulation
Uygun, D. S., & Basheer, R. (2022) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2022.06.006 · Cited by 60
Eszopiclone for insomnia
Rösner, S., Englbrecht, C., Wehrle, R., Hajak, G., & Soyka, M. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010703.pub2 · Cited by 62
Lack of residual morning effects of lemborexant treatment for insomnia: summary of findings across 9 clinical trials
Moline, M. L., Zammit, G. K., Yardley, J., Pinner, K., Kumar, D., Perdomo, C. A., & Cheng, J. Y. (2020) · Postgraduate Medicine · doi:10.1080/00325481.2020.1823724 · Cited by 54
Benzodiazepines, z-Hypnotics, and Risk of Dementia: Special Considerations of Half-Lives and Concomitant Use
Tseng, L.-Y., Huang, S., Peng, L., Chen, L., & Hsiao, F. (2019) · Neurotherapeutics · doi:10.1007/s13311-019-00801-9 · Cited by 54
Quality Measures for the Care of Patients with Insomnia
Edinger, J. D., Buysse, D. J., Deriy, L. V., Germain, A., Lewin, D. S., Ong, J. C., & Morgenthaler, T. I. (2015) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4552 · Cited by 51
Zolpidem use and risk of fractures: a systematic review and meta-analysis
Park, S.-M., Ryu, J. K., Lee, D. R., Shin, D., Yun, J. M., & Lee, J. (2016) · Osteoporosis International · doi:10.1007/s00198-016-3605-8 · Cited by 49
Prescription Drugs Used in Insomnia
Dujardin, S., Pijpers, A., & Pevernagie, D. (2020) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2020.02.002 · Cited by 52
The Quest for the Best Dual Orexin Receptor Antagonist (Daridorexant) for the Treatment of Insomnia Disorders
Boss, C., Gatfield, J., Brotschi, C., Heidmann, B., Sifferlen, T., von Raumer, M., Schmidt, G., Williams, J. T., Treiber, A., & Roch, C. (2020) · ChemMedChem · doi:10.1002/cmdc.202000453 · Cited by 49
An evidence-based approach to psychopharmacology for posttraumatic stress disorder (PTSD) -2022 update
Bajor, L. A., Balsara, C., & Osser, D. N. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114840 · Cited by 43
Use of Sedative-Hypnotics and Mortality: A Population-Based Retrospective Cohort Study
Choi, J.-W., Lee, J., Jung, S. J., Shin, A., & Lee, Y. J. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7370 · Cited by 39
The hypocretin/orexin antagonist almorexant promotes sleep without impairment of performance in rats
Morairty, S. R., Wilk, A. J., Lincoln, W. U., Neylan, T. C., & Kilduff, T. S. (2014) · Frontiers in Neuroscience · doi:10.3389/fnins.2014.00003 · Cited by 38
Prescription Drugs Used in Insomnia
Dujardin, S., Pijpers, A., & Pevernagie, D. (2018) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2018.03.001 · Cited by 40
Zolpidem Reduces Hippocampal Neuronal Activity in Freely Behaving Mice: A Large Scale Calcium Imaging Study with Miniaturized Fluorescence Microscope
Berdyyeva, T. K., Otte, S. L., Aluisio, L. E., Ziv, Y., Burns, L. D., Dugovic, C., Yun, S., Ghosh, K. K., Schnitzer, M. J., Lovenberg, T. W., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0112068 · Cited by 36
Preoperative Sedative-hypnotic Medication Use and Adverse Postoperative Outcomes
Gaulton, T. G., Wunsch, H., Gaskins, L. J., Leonard, C. E., Hennessy, S., Ashburn, M. A., Brensinger, C. M., Newcomb, C., Wijeysundera, D. N., Bateman, B. T., et al. (2019) · Annals of Surgery · doi:10.1097/sla.0000000000003556 · Cited by 35
A Randomized, Double-Blind, Single-Dose, Placebo-Controlled, Multicenter, Polysomnographic Study of Gabapentin in Transient Insomnia Induced by Sleep Phase Advance
Rosenberg, R. P., Hull, S. G., Lankford, D. A., Mayleben, D. W., Seiden, D., Furey, S. A., Jayawardena, S., & Roth, T. G. (2014) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4108 · Cited by 36
Sustained Use of Benzodiazepines and Escalation to High Doses in a Canadian Population
Alessi‐Severini, S., Bolton, J. M., Enns, M. W., Dahl, M. E., Chateau, D. G., Collins, D. M., & Sareen, J. (2016) · Psychiatric Services · doi:10.1176/appi.ps.201500380 · Cited by 34
Adverse Events Due to Insomnia Drugs Reported in a Regulatory Database and Online Patient Reviews: Comparative Study
Borchert, J. S., Wang, B., Ramzanali, M., Stein, A. B., Malaiyandi, L. M., & Dineley, K. E. (2019) · Journal of Medical Internet Research · doi:10.2196/13371 · Cited by 34
Insomnia, hypnotic use, and health-related quality of life in a nationally representative sample
Scalo, J., Desai, P., & Rascati, K. L. (2014) · Quality of Life Research · doi:10.1007/s11136-014-0842-1 · Cited by 33
Gut microbiome and metabolic pathways linked to sleep quality
Seong, H. J., Baek, Y., Lee, S., & Jin, H. (2024) · Frontiers in Microbiology · doi:10.3389/fmicb.2024.1418773 · Cited by 35
Insomnia and related mental health conditions: Essential neurobiological underpinnings towards reduced polypharmacy utilization rates
Fornaro, M., Caiazza, C., Simone, G. D., Rossano, F., & de Bartolomeis, A. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.11.033 · Cited by 28
Enhancement of zaleplon oral bioavailability using optimized self-nano emulsifying drug delivery systems and its effect on sleep quality among a sample of psychiatric patients
Khalifa, M. K. A., Salem, H. A., Shawky, S., Eassa, H. A., & Elaidy, A. M. (2019) · Drug Delivery · doi:10.1080/10717544.2019.1687613 · Cited by 25
The abuse potential of lemborexant, a dual orexin receptor antagonist, according to the 8 factors of the Controlled Substances Act
Moline, M. L., Asakura, S., Beuckmann, C. T., Landry, I. S., Setnik, B., Ashworth, J., & Henningfield, J. E. (2023) · Psychopharmacology · doi:10.1007/s00213-023-06320-y · Cited by 25
The dual orexinergic receptor antagonist DORA-22 improves the sleep disruption and memory impairment produced by a rodent insomnia model
Gamble, M. C., Katsuki, F., McCoy, J. G., Strecker, R. E., & McKenna, J. T. (2019) · SLEEP · doi:10.1093/sleep/zsz241 · Cited by 24
To sleep or not to sleep – Effects on memory in normal aging and disease
Kroeger, D., & Vetrivelan, R. (2023) · Aging Brain · doi:10.1016/j.nbas.2023.100068 · Cited by 28
BDZs, Designer BDZs and Z-drugs: Pharmacology and Misuse Insights
Zaami, S., Graziano, S., Tittarelli, R., Beck, R., & Marinelli, E. (2021) · Current Pharmaceutical Design · doi:10.2174/1381612827666210917145636 · Cited by 22
Population Pharmacokinetics and Exposure‐Response Analyses for the Most Frequent Adverse Events Following Treatment With Lemborexant, an Orexin Receptor Antagonist, in Subjects With Insomnia Disorder
Lalovic, B. B., Majid, O., Aluri, J., Landry, I. S., Moline, M. L., & Hussein, Z. (2020) · The Journal of Clinical Pharmacology · doi:10.1002/jcph.1683 · Cited by 22
Emerging and upcoming therapies in insomnia
Kim, W.-J., & Kim, H.-S. (2024) · Translational and Clinical Pharmacology · doi:10.12793/tcp.2024.32.e5 · Cited by 23
Advancements in chemical methodologies for the synthesis of 3-aroylimidazo[1,2-a]pyridines: an update of the decade
Rawat, R., & Verma, S. M. (2020) · Synthetic Communications · doi:10.1080/00397911.2020.1803915 · Cited by 21
Effects of Japanese policies and novel hypnotics on long‐term prescriptions of hypnotics
Takeshima, M., Yoshizawa, K., Enomoto, M., Ogasawara, M., Kudo, M., Itoh, Y., Ayabe, N., Takaesu, Y., & Mishima, K. (2022) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13525 · Cited by 21
Mindfulness-based Cognitive Therapy to Improve Sleep Quality in Older Adults with Insomnia
Camino, M., Satorres, E., Delhom, I., Real, E., Abella, M., & Meléndez, J. C. (2022) · Psychosocial Intervention · doi:10.5093/pi2022a12 · Cited by 26
Mesoporous particle-based microcontainers for intranasal delivery of imidazopyridine drugs
Marchenko, I. V., Borodina, T. N., Trushina, D. B., Rassokhina, I., Volkova, Y. A., Ширинян, В. З., Zavarzin, I. V., Gogin, A. A., & Букреева, Т. В. (2018) · Journal of Microencapsulation · doi:10.1080/02652048.2019.1571642 · Cited by 19
Understanding and reducing the prescription of hypnotics and sedatives at the interface of hospital care and general practice: a protocol for a mixed-methods study
Heinemann, S., Weiß, V., Straube, K., Nau, R., Grimmsmann, T., Himmel, W., & Hummers, E. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011908 · Cited by 18
Reducing unnecessary sedative-hypnotic use among hospitalised older adults
Fan‐Lun, C., Chung, C., Lee, E. H. G., Pek, E., Ramsden, R., Ethier, C., & Soong, C. (2019) · BMJ Quality & Safety · doi:10.1136/bmjqs-2018-009241 · Cited by 18
Sleep loss, sleep disorders and driving accidents
Inoue, Y., & Komada, Y. (2014) · Sleep and Biological Rhythms · doi:10.1111/sbr.12064 · Cited by 18
The Dual Hypocretin Receptor Antagonist Almorexant is Permissive for Activation of Wake-Promoting Systems
Parks, G. S., Warrier, D. R., Dittrich, L., Schwartz, M. D., Palmerston, J. B., Neylan, T. C., Morairty, S. R., & Kilduff, T. S. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.256 · Cited by 17
Synthesis of functionalyzed imidazo[1,2-a]pyridines via domino A3-coupling/cycloisomerization approach
Volkova, Y. A., & Gevorgyan, V. (2017) · Chemistry of Heterocyclic Compounds · doi:10.1007/s10593-017-2066-0 · Cited by 16
TBI and Sleep–Wake Disorders: Pathophysiology, Clinical Management, and Moving towards the Future
Baumann, C. R., & Werner, J. K. (2017) · Seminars in Neurology · doi:10.1055/s-0037-1604487 · Cited by 16
Z-drug for schizophrenia: A systematic review and meta-analysis
Kishi, T., Inada, K., Matsui, Y., & Iwata, N. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.06.063 · Cited by 16
Benzodiazepine und Z-Substanzen – Analyse der kassenärztlichen Verschreibungen von 2006 bis 2015
Verthein, U., Buth, S., Holzbach, R., Neumann-Runde, E., & Martens, M. (2019) · Psychiatrische Praxis · doi:10.1055/a-0961-2371 · Cited by 16
Trazodone and mirtazapine: A possible opioid involvement in their use (at low dose) for sleep?
Schreiber, S., & Pick, C. G. (2019) · Medical Hypotheses · doi:10.1016/j.mehy.2019.109501 · Cited by 15
Assessment of cognitive safety in clinical drug development
Roiser, J. P., Nathan, P. J., Mander, A., Adusei, G. O., Zavitz, K. H., & Blackwell, A. D. (2015) · Drug Discovery Today · doi:10.1016/j.drudis.2015.11.003 · Cited by 15
Trazodone and cognitive performance in Alzheimer disease
Camargos, E. F., Quintas, J. L., Louzada, L. L., Naves, J. O. S., Furioso, A. C. T., & Nóbrega, O. T. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000237 · Cited by 14
Efficacy and tolerability of Z-drug adjunction to antidepressant treatment for major depressive disorder: a systematic review and meta-analysis of randomized controlled trials
Kishi, T., Matsunaga, S., & Iwata, N. (2016) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0706-5 · Cited by 15
Neurotransmitter modulation of sleep-wake States: From molecular mechanisms to therapeutic potential
Ye, X., Pang, S., Ren, X., Wang, H., & Chen, M. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106547 · Cited by 18
Symptom Presentation and Prescription of Sleep Medications for Veterans With Posttraumatic Stress Disorder
Greenbaum, M. A., Neylan, T. C., & Rosen, C. S. (2017) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000657 · Cited by 13
The interplay of context factors in hypnotic and sedative prescription in primary and secondary care—a qualitative study
Weiß, V., Nau, R., Glaeske, G., Hummers, E., & Himmel, W. (2018) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-018-2555-9 · Cited by 14
Ten-year trend in sleeping pills use in Switzerland: the CoLaus study
Abolhassani, N., Haba‐Rubio, J., Heinzer, R. C., Vollenweider, P., & Marques-Vidal, P. M. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2018.06.022 · Cited by 14
Silexan does not affect driving performance after single and multiple dose applications: Results from a double-blind, placebo and reference-controlled study in healthy volunteers
Möller, H., Volz, H., Seifritz, E., Müller, H., Kenntner‐Mabiala, R., Kaußner, Y., Schoch, S., & Kasper, S. F. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.10.028 · Cited by 13
Implementing computer-based psychotherapy among veterans in outpatient treatment for substance use disorders
Hermes, E. D. A., & Rosenheck, R. A. (2016) · Psychiatric Services · doi:10.1176/appi.ps.201400532 · Cited by 12
Cannabis Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.013 · Cited by 12
Use of potentially driver-impairing drugs among older drivers
Zitoun, S., Baudouin, É., Corruble, E., Vidal, J., Becquemont, L., & Duron, E. (2022) · BMC Geriatrics · doi:10.1186/s12877-021-02726-5 · Cited by 13
Prescription of Zolpidem and the Risk of Fatal Motor Vehicle Collisions: A Population-Based, Case-Crossover Study from South Korea
Yang, B. R., Kim, Y., Kim, M., Jung, S., Choi, N., Hwang, B., Park, B., & Lee, J. (2018) · CNS Drugs · doi:10.1007/s40263-018-0520-x · Cited by 11
LC–MS-MS with Post-Column Reagent Addition for the Determination of Zolpidem and its Metabolite Zolpidem Phenyl-4-carboxylic Acid in Oral Fluid after a Single Dose
Feng, X., Xiang, P., Chen, H., & Shen, M. (2017) · Journal of Analytical Toxicology · doi:10.1093/jat/bkx062 · Cited by 10
The acute effects of aerobic exercise on sleep in patients with depression: study protocol for a randomized controlled trial
Brupbacher, G., Straus, D., Porschke, H., Zander-Schellenberg, T., Gerber, M., von Känel, R., & Schmidt‐Trucksäss, A. (2019) · Trials · doi:10.1186/s13063-019-3415-3 · Cited by 11
The effects of aerobic, resistance, and meditative movement exercise on sleep in individuals with depression: protocol for a systematic review and network meta-analysis
Brupbacher, G., Gerger, H., Wechsler, M., Zander-Schellenberg, T., Straus, D., Porschke, H., Gerber, M., von Känel, R., & Schmidt‐Trucksäss, A. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1018-4 · Cited by 11
Fast and Simple Preparation of a Sensor Based on Electrochemically Reduced Graphene Oxide (rGO) for the Determination of Zopiclone in Pharmaceutical Dosage by Square Wave Adsorptive Stripping Voltammetry (SWAdSV)
Navarro, F., Segura, R., Godoy, F., Martı́, A. A., Mascayano, C., Aguirre, M. J., Flores, E., & Pizarro, J. (2022) · Electroanalysis · doi:10.1002/elan.202200357 · Cited by 9
Prescription Drugs Used in Insomnia
Dujardin, S., Pijpers, A., & Pevernagie, D. (2022) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2022.06.001 · Cited by 11
The Effect of Lowering the Legal Drink‐Drive Limit on the Toxicological Findings in Driver Fatalities: A Comparison of Two Jurisdictions,
Hamnett, H. J., & Poulsen, H. (2018) · Journal of Forensic Sciences · doi:10.1111/1556-4029.13747 · Cited by 9
Assessment of morning sleep propensity with lemborexant in adults with insomnia disorder in a randomized, placebo-controlled crossover study
Mayleben, D. W., Rosenberg, R. P., Pinner, K., Hussein, Z., & Moline, M. L. (2021) · SLEEP Advances · doi:10.1093/sleepadvances/zpab011 · Cited by 8
Discovery of Small-Molecule Antagonists of Orexin 1/2 Receptors from Traditional Chinese Medicinal Plants with a Hypnotic Effect
He, J., Fang, J. S., Wang, Y., Ge, C., Liu, S., & Jiang, Y. (2023) · Pharmaceuticals · doi:10.3390/ph16040542 · Cited by 8
Discontinuation of benzodiazepines and Z‐drugs in hospitalised population at the age of 60 and above. An open‐label randomized controlled trial
Kosto, A., Lev, D. Z., Reiss, N., Meged‐Book, T., & Press, Y. (2023) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.6012 · Cited by 8
Lorediplon: A New GABAA Modulator Drug for Treatment of Insomnia
Aniello, F. D., Santos, B., & Guglietta, A. (2014) · Milestones in drug therapy · doi:10.1007/978-3-319-11514-6_6 · Cited by 8
Psychotropic medication use in hospitalized patients with borderline personality disorder
Moeller, K. E., Din, A. U., Wolfe, M., & Holmes, G. (2016) · Mental Health Clinician · doi:10.9740/mhc.2016.03.68 · Cited by 8
Sedative Hypnotics
Ciraulo, D. A., & Oldham, C. M. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-418679-8.00016-2 · Cited by 8
The dual orexin receptor antagonist, DORA‐22, lowers histamine levels in the lateral hypothalamus and prefrontal cortex without lowering hippocampal acetylcholine
Yao, L., Ramirez, A. D., Roecker, A. J., Fox, S. V., Uslaner, J. M., Smith, S. M., Hodgson, R. A., Coleman, P. J., Renger, J. J., Winrow, C. J., et al. (2017) · Journal of Neurochemistry · doi:10.1111/jnc.14055 · Cited by 8
Acute insomnia: natural course and correction modalities
Melnikov, A. Y. (2019) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro201911904228 · Cited by 7
Verordnung von Benzodiazepinen und Z-Drugs in hausärztlichen Praxen – eine Querschnittanalyse
Moßhammer, D., Haumann, H., Muche, R., Scheub, D., Joos, S., & Laux, G. (2017) · Das Gesundheitswesen · doi:10.1055/s-0043-104694 · Cited by 6
Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515 · Cited by 8
Geriatric Polypharmacy
Fritsch, M. A., & Shelton, P. S. (2017) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2017.01.003 · Cited by 6
Benzodiazepine und Z-Substanzen als Schlaf- und Beruhigungsmittel in einem Krankenhaus
Weiß, V., Heinemann, S., Himmel, W., Nau, R., & Hummers, E. (2016) · DMW - Deutsche Medizinische Wochenschrift · doi:10.1055/s-0042-102618 · Cited by 5
Case Report: High doses of Zolpidem and QT interval lengthening: Is there a relationship? A case series
Campagnari, S., Zamboni, L., Fusina, F., Casari, R., & Lugoboni, F. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1033061 · Cited by 5
Longitudinal effects of using and discontinuing central nervous system medications on cognitive functioning
Koch, E. M., Johnell, K., & Kauppi, K. (2022) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.5569 · Cited by 5
Geriatric Polypharmacy
Fritsch, M. A., & Shelton, P. S. (2019) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2019.01.010 · Cited by 5
Development and validation of a practical analytical method for Zolpidem as a drug facilitated crime tool
Kenan, N., Mercan, S., & Açıkkol, M. (2019) · Journal of Chemical Metrology · doi:10.25135/jcm.33.19.12.1498 · Cited by 5
Effect of magnetic stimulation of Shenmen point on cognitive function of chronic insomnia
Yuan, J., Chen, Y., Yu, P., Luo, F., Gao, Y., Chen, J., Wang, P., Wang, Y., Zhao, Y., & Lei, Y. (2020) · Medicine · doi:10.1097/md.0000000000023807 · Cited by 5
Benzodiazepine and Nonbenzodiazepine Hypnotics (Z-Drugs): The Other Epidemic
Umbricht, A., & Vélez, M. L. (2020) · Springer eBooks · doi:10.1007/978-3-030-36391-8_11 · Cited by 5
Zopiclone as a Potent Positive Control for Assessing the Residual Effects of Hypnotic Drugs on Next Day Driving Performance: A Systematic Review
Karhana, S., Hussain, S., Zehgeer, M. M., & Khan, M. A. (2025) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.70007 · Cited by 4
Driving under the influence of zopiclone: Elimination between two consecutive blood samples
Strand, M. C., Bleka, Ø., Kristoffersen, L., & Høiseth, G. (2023) · Forensic Science International · doi:10.1016/j.forsciint.2023.111764 · Cited by 4
A Review of Drug Abuse, Misuse, and Related Laboratory Challenges
Ranjkeshzadeh, H., Sepahi, S., Zare‐Zardini, H., Yazdi, M. E. T., Ghorani‐Azam, A., & Jafari, A. (2023) · Current Drug Safety · doi:10.2174/0115748863266621231023112044 · Cited by 4
Sleep Medicine and the Evolution of Contemporary Sleep Pharmacotherapy
Larrivee, D. C. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.91536 · Cited by 4
Sedatives and hypnotics
Haghparast, P., Pondrom, M., & Ray, S. D. (2020) · Side effects of drugs annual · doi:10.1016/bs.seda.2020.08.008 · Cited by 4
Benzodiazepine Abuse and Addiction
Umbricht, A., & Velez, M. L. (2015) · Textbook of Addiction Treatment: International Perspectives · doi:10.1007/978-88-470-5322-9_102 · Cited by 3
The effect of Dual Orexin Receptor Antagonists on sleep: a systematic review and pairwise meta-analysis
Stefanou, A., Lampropoulou, P., Papageorgiou, P., Boskou, I., Lappas, A. S., Christodoulou, N., Bozikas, V., & Samara, M. T. (2026) · Sleep Medicine · doi:10.1016/j.sleep.2026.108792 · Cited by 3
Sleep, wake, and signaling: Functional profiling of orexin agonists and antagonists using newly developed orexin β-arrestin 2 and miniGαq recruitment assays
Deventer, M. H., Mori, S., Angermann, M., Decker, M. W., & Stove, C. P. (2026) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2026.178591 · Cited by 3

Authors: Gunja, N.
Affiliations: Children's Hospital at Westmead (AU)
Corresponding author: Gunja, Naren
ORCID: Gunja, Naren
Venue: Journal of Medical Toxicology
Publisher: Springer Science and Business Media LLC
Published: 2013-03-02
Volume: 9
Issue: 2
Pages: 163-171
ISSN: 1556-9039 (ISSN-L)
1937-6995
DOI: 10.1007/s13181-013-0294-y
PMC: PMC3657033
OpenAlex: W1966792529
Cited by: 177
References: 85
Citations by year: 2026: 5 · 2025: 6 · 2024: 5 · 2023: 14 · 2022: 16 · 2021: 11 · 2020: 35 · 2019: 19 · 2018: 13 · 2017: 12 · 2016: 13 · 2015: 11 · 2014: 16 · 2013: 1
FWCI: 2.26
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Medical Toxicology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
Keywords: Z-drugs, zolpidem, zopiclone, zaleplon, driving impairment, psychomotor performance, cognitive impairment, anterograde amnesia, sleepwalking, hallucinations, falls, hip fracture, traffic accidents, alcohol-drug interactions, insomnia treatment, elderly patients, benzodiazepine adverse effects, GABA agonists
MeSH terms: Zolpidem, Acetamides, Automobile Driving, Humans, Hypnotics and Sedatives, Piperazines, Psychomotor Disorders, Psychomotor Performance, Pyridines, Pyrimidines, Azabicyclo Compounds, GABA-A Receptor Agonists

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

In the Zzz Zone: The Effects of Z-Drugs on Human Performance and Driving

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks