Which medications in the drug class Nonbenzodiazepine Hypnotics are used in the treatment of Sleep Dysfunction in Women?

Updated: Jan 31, 2019
  • Author: Gila Hertz, PhD, ABSM; Chief Editor: Selim R Benbadis, MD  more...
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Nonbenzodiazepine Hypnotics

These agents are used for the treatment of acute and short-term insomnia.

Zolpidem (Ambien, Ambien CR, Edluar, Intermezzo)

Zolpidem is the drug of choice (DOC) for the treatment of primary insomnia (ie, sleep-onset insomnia). It is indicated for acute, short-term insomnia for a duration that does not exceed a few weeks. The extended-release product (Ambien CR) consists of a coated, 2-layer tablet and is useful for insomnia characterized by difficulties with sleep onset and/or sleep maintenance. The first layer releases the drug content immediately to induce sleep; the second layer gradually releases additional drug to provide continuous sleep..

Zaleplon (Sonata)

Zaleplon is a nonbenzodiazepine hypnotic from the pyrazolopyrimidine class. It has a chemical structure unrelated to benzodiazepines, barbiturates, or other hypnotic drugs but interacts with the GABA-benzodiazepine receptor complex. It binds selectively to the omega-1 receptor situated on the alpha subunit of the GABAA receptor complex in the brain. Zaleplon potentiates t-butyl-bicyclophosphorothionate (TBPS) binding and has preferential binding to the omega-1 receptor of the GABA receptor family. It is indicated for short term treatment of insomnia. It should be used for 7-10 days. Zaleplon has been shown to cause minimal daytime grogginess

Eszopiclone (Lunesta)

Eszopiclone is a nonbenzodiazepine hypnotic pyrrolopyrazine derivative of the cyclopyrrolone class. The precise mechanism of action is unknown, but the drug is believed to interact with the GABA receptor at binding domains close to or allosterically coupled with benzodiazepine receptors.

Eszopiclone is indicated for insomnia to decrease sleep latency and improve sleep maintenance. It has a short half-life of 6 hours. Higher doses (ie, 2 mg for elderly adults and 3 mg for nonelderly adults) are more effective for sleep maintenance, whereas lower doses (ie, 1 mg for elderly adults and 2 mg for nonelderly adults) are suitable for difficulty in falling asleep.

Ramelteon (Rozerem)

Ramelteon is a melatonin receptor agonist with high selectivity for human melatonin MT1 and MT2 receptors. MT1 and MT2 are thought to promote sleep and to be involved in the maintenance of circadian rhythm and the normal sleep-wake cycle.

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