Amnestic sleep-related eating disorder associated with zolpidem
Abstract
Objective To describe the association of amnestic nocturnal eating behavior with use of zolpidem for insomnia.Background Sleep-related eating disorder is increasingly recognized in relationship to other diagnosable sleep disorders. Many of these disorders, like restless legs syndrome (RLS), give rise to complaints of insomnia. Zolpidem is the most commonly prescribed drug for insomnia complaints, and although it has sometimes been associated with side effects of transient amnesia and sleep walking, an association with sleep-related eating has not been previously emphasized.Methods Consecutive case series of five patients who were using zolpidem and evaluated with nocturnal eating behaviors.Results We evaluated five patients over 11 months with problematic amnestic nocturnal eating associated with zolpidem used for complaints of insomnia. All five patients had RLS, three had obstructive sleep apnea syndrome, two had sleep walking, and one had psychophysiologic insomnia. With discontinuation of zolpidem and effective treatment of their sleep disorders, nocturnal eating resolved.Conclusions Zolpidem, at least in patients with underlying sleep disorders that cause frequent arousals, may cause or augment sleep-related eating behavior. This report demonstrates the importance of arriving at a specific diagnosis for insomnia complaints, and alerts the sleep practitioner to this unusual side effect of zolpidem.
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Withdrawal syndromes after decrease or discontinuation of antidepressants may be associated with additional clinical manifestations, including modifications of the illness course such as switching to mania or other forms of excessive behavioral activations, loss of clinical effects, and refractoriness to treatment.
“Withdrawal syndromes after decrease or discontinuation of antidepressants may be associated with additional clinical manifestations. They include modifications of the illness course, such as switching to mania or other forms of excessive behavioral activations [24], but also loss of clinical effects and refractoriness to treatment; they have been reported with SSRI and SNRI [5, 6, 27].”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [27]
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“Importantly, zolpidem has been associated with triggering amnestic nocturnal eating in patients with and without NES [103, 104].”
BackgroundA Case of Zaleplon-Induced Amnestic Sleep-Related Eating Disorder
Molina, S. M., & Joshi, K. G. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09l05364bro · Cited by 22 · see citing works
“Some had nocturnal eating syndrome that increased in frequency and/or evolved into a SRED with new amnesia for the eating.(3) Others had simple sleepwalking that evolved into more complex behaviors.”
BackgroundAdvances in the management of insomnia
Zhdanova, I. V. (2004) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.5.7.1573 · Cited by 22 · see citing works
“Even though sleep-promoting properties of NB-BZRAs are comparable to those of benzodiazepines, they have a much better safety profile, although both amnesia and drug dependence remain potential side effects [21-32].”
BackgroundIs suvorexant a better choice than alternative hypnotics?
Kripke, D. F. (2015) · F1000Research · doi:10.12688/f1000research.6845.1 · Cited by 19 · see citing works
“Symptoms of this kind, of which “zombie driving” is an example, occur with other hypnotics and have become somewhat notorious with triazolam and zolpidem 41–44 .”
Sleep self-intoxication and sleep driving as rare zolpidem-induced complex behaviour
Paulke, A., Wunder, C., & Toennes, S. W. (2014) · International Journal of Legal Medicine · doi:10.1007/s00414-014-0997-x · Cited by 20 · see citing works
“sleepwalking [3, 4], sleep cleaning [15], sleep eating [4, 5, 16], sleep conversation [15, 17] and sleep driving [4, 11]).”
BackgroundSleep-related eating disorder associated with zolpidem: cases compiled from a literature review
Ho, T., Jimenez, A., Sanchez, I., Seeger, C., & Joseph, M. (2020) · Sleep Medicine: X · doi:10.1016/j.sleepx.2020.100019 · Cited by 17 · see citing works
“Furthermore, discontinuation of zolpidem resolved SRED in both cases [8].”
BackgroundMittal, N., Mittal, R., & Gupta, M. C. (2021) · Indian Journal of Psychological Medicine · doi:10.1177/0253717621992372 · Cited by 18 · see citing works
Desensitization of GABAergic receptors as a mechanism of zolpidem-induced somnambulism
Juszczak, G. R. (2011) · Medical Hypotheses · doi:10.1016/j.mehy.2011.04.019 · Cited by 18 · see citing works
Tzeng, N., Chen, L., Lin, C., Chou, Y., Mao, W.-C., & Chen, Y. C. (2013) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s48152 · Cited by 18 · see citing works
Two Cases of Sleep-Related Eating Disorder Responding Promptly to Low-Dose Sertraline Therapy
Varghese, R., de Castro, J. R., Liendo, C., & Schenck, C. H. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7404 · Cited by 18 · see citing works
“The use of hypnotics, es - pecially zolpidem, can induce amnestic SRED, 8,26,27 especially in cases with occult RLS. 26 Benzodiazepines have been implicated in inducing or worsening SRED, and clonazepam in - creased the frequency of SRED in case 1.”
Bhidayasiri, R., Sringean, J., Rattanachaisit, W., & Truong, D. D. (2017) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2017.01.018 · Cited by 18 · see citing works
Kobayashi, N., Yoshimura, R., & Takano, M. (2012) · Case Reports in Medicine · doi:10.1155/2012/893681 · Cited by 17 · see citing works
Plante, D. T., & Winkelman, J. W. (2006) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2006.08.006 · Cited by 16 · see citing works
Parasomnias: Psychiatric Considerations
Plante, D. T., & Winkelman, J. W. (2008) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2008.01.005 · Cited by 16 · see citing works
Zolpidem Use and Suicide Death in South Korea: A Population‐Based Case–Control Study
Choi, B., Sung, H. G., Nam, J. H., & Shin, J. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12548 · Cited by 16 · see citing works
Pharmacotherapy of Insomnia: Focus on Zolpidem Extended Release
Monti, J. M., Spence, D. W., Pandi-Perumal, S. R., Langer, S. Z., & Hardeland, R. (2009) · Clinical Medicine Therapeutics · doi:10.4137/cmt.s2040 · Cited by 16 · see citing works
Sleep Profiles in Eating Disorders: A Scientometric Study on 50 Years of Clinical Research
Carollo, A., Zhang, P., Yin, P., Jawed, A., Dimitriou, D., Esposito, G., & Mangar, S. A. (2023) · Healthcare · doi:10.3390/healthcare11142090 · Cited by 15 · see citing works
“The following documents in terms of citation burstness were authored by Morgenthaler and Silber [44] (burst strength = 6.7376; duration = 4 years) and by Howell et al. [45] (burst strength = 5.9064; duration = 2 years).”
MethodInfluentialVasiliu, O. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1393337 · Cited by 18 · see citing works
“In a case series, fi ve patients were monitored for 11 months for episodes of nocturnal eating behaviors followed by amnesia that had their onset after zolpidem administration (54).”
BackgroundComparison of clinical features between primary and drug-induced sleep-related eating disorder
Komada, Y., Takaesu, Y., Matsui, K., Nakamura, M., Nishida, S., Kanno, M., Usui, A., & Inoue, Y. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s107462 · Cited by 15 · see citing works
“24 However, in this study, both the PLM index and AHI were in the normal range in the subject of two groups, because we targeted primary SRED without any comorbid sleep disorders and drug-induced SRED.”
InfluentialBenca, R. M., & Schenck, C. H. (2005) · Elsevier eBooks · doi:10.1016/b0-72-160797-7/50121-x · Cited by 15 · see citing works
Chapter 87 – Pharmacologic Treatment of Insomnia: Benzodiazepine Receptor Agonists
Walsh, J., & Roth, T. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-24288-2.00087-8 · Cited by 7 · see citing works
Mahowald, M. W. (2004) · Medical Clinics of North America · doi:10.1016/j.mcna.2004.01.003 · Cited by 14 · see citing works
[Sleep related eating disorders as a side effect of zolpidem].
Valiensi, S. M., Cristiano, E., Martínez, O. A., Reisin, R. C., & Alvarez, F. (2010) · PubMed · Cited by 13 · see citing works
Long-Term Follow-Up of Patients with Insomnia
Rosenthal, L. D., Dolan, D. C., Taylor, D. J., & Grieser, E. (2008) · Baylor University Medical Center Proceedings · doi:10.1080/08998280.2008.11928409 · Cited by 13 · see citing works
Malhotra, R. K., & Avidan, A. Y. (2012) · Neurologic Clinics · doi:10.1016/j.ncl.2012.08.016 · Cited by 13 · see citing works
“Use of hypnotics along with cessation of smoking or alcohol have also been reported as triggers.(30) There is a female predominance, with the mean age of onset at 22 to 29 years of age.”
BackgroundDuke, A. N., Platt, D. M., Cook, J. M., Huang, S., Yin, W., Mattingly, B. A., & Rowlett, J. K. (2006) · Psychopharmacology · doi:10.1007/s00213-006-0431-2 · Cited by 13 · see citing works
“The clinical use of BZs is associated with several unwanted side effects, one of which is increased food intake which can result in weight gain, decreased patient compliance, and nighttime bingeing (cf. Morgenthaler and Silber 2002).”
BackgroundZolpidem-Associated Parasomnia with Serious Self-Injury: A Shot in the Dark
Gibson, C. E., & Caplan, J. P. (2011) · Psychosomatics · doi:10.1016/j.psym.2010.11.015 · Cited by 13 · see citing works
Kouri, I., Junna, M. R., & Lipford, M. C. (2022) · Journal of Clinical Neurophysiology · doi:10.1097/wnp.0000000000000934 · Cited by 12 · see citing works
Lee, J., Hwang, S. J., Ham, S. L., Kim, J., Bang, H. J., Park, J., Jang, H.-H., Kim, T. Y., Park, J. W., Seo, Y. R., et al. (2024) · ACS Omega · doi:10.1021/acsomega.4c06923 · Cited by 12 · see citing works
Current Clinical Practice of Insomnia
Choi, H. Y., & Lim, W. (2013) · Ewha Medical Journal · doi:10.12771/emj.2013.36.2.84 · Cited by 12 · see citing works
“또한 졸림, 어지러 움 등의 부작용이 나타날 수 있으며, 수면 중 식사, 청소, 운전 등 이상행동이 보고되었는데 이 경우 환자는 본인의 행동을 기억하 지 못한다[32].”
Zolpidem-Induced Compulsive Evening Eating Behavior
Kim, H. K., Kwon, J. T., Baek, J., Park, D. S., & Yang, K. I. (2013) · Clinical Neuropharmacology · doi:10.1097/wnf.0b013e31829dd448 · Cited by 12 · see citing works
Sleep Related Amnestic Behaviors due to Zolpidem
Cubała, W. J., & Gabrielsson, A. (2014) · Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology · doi:10.5455/bcp.20130527020102 · Cited by 11 · see citing works
Sleep-Related Eating Disorder Associated With Mirtazapine
Jeong, J., & Bahk, W. (2014) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000216 · Cited by 11 · see citing works
“An important note is that our overall rates of fatal outcomes in our cohort are higher than what was identified by Stephansson et al.(3) This could be a manifestation of our cohort being derived from a single specialist tertiary level teaching hospital that is likely to attract high-risk pregnancies,(2) as opposed to…”
ResultInfluentialConductas complejas durante el sueño inducidas por zolpidem
Pérez-Díaz, H., Iranzo, Á., & Santamaría, J. (2010) · Neurología · doi:10.1016/j.nrl.2010.07.001 · Cited by 10 · see citing works
Transient Global Amnesia-like Episode Due to Mistaken Intake of Zolpidem
Tsai, M.-Y., Tsai, M., Yang, S.-C., Tseng, Y., & Chuang, Y. (2009) · Journal of Patient Safety · doi:10.1097/pts.0b013e3181990d62 · Cited by 10 · see citing works
Managing Insomnia in Older People
Woodward, M. C. (2007) · Journal of Pharmacy Practice and Research · doi:10.1002/j.2055-2335.2007.tb00754.x · Cited by 10 · see citing works
Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit
Kripke, D. F. (2017) · F1000Research · doi:10.12688/f1000research.8729.2 · Cited by 12 · see citing works
Parasomnias Occurring in Non–Rapid Eye Movement Sleep
Silber, M. H. (2020) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000000877 · Cited by 9 · see citing works
Self-citation
- Authors
- Morgenthaler, T. I., & Silber, M. H.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Morgenthaler, Timothy I
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 3
- Issue
- 4
- Pages
- 323-327
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W2162977548
- Cited by
- 185
- References
- 33
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 8 · 2019: 5 · 2018: 7 · 2017: 3 · 2016: 9 · 2015: 4 · 2014: 11 · 2013: 17 · 2012: 10
- FWCI
- 5.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Epidemiology › Restless Legs Syndrome Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep-related eating disorder, zolpidem, drug-induced amnesia, insomnia, restless legs syndrome, obstructive sleep apnea, sleepwalking, hypnotic side effects
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