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Zolpidem, sold under the brand name Ambien, among others, is a medication primarily used for the short-term treatment of sleeping problems.[7][8] Guidelines recommend that it be used only after cognitive behavioral therapy for insomnia and behavioral changes, such as sleep hygiene, have been tried.[9][10][11] It decreases the time to sleep onset by about fifteen minutes and at larger doses helps people stay asleep longer.[5] It is taken by mouth and is available in conventional tablets, sublingual tablets, or oral spray.[7]

Common side effects include daytime sleepiness, headache, nausea, and diarrhea.[7] Other side effects include memory problems, hallucinations, and substance abuse.[5] The previously recommended dose was decreased in 2013, by the US Food and Drug Administration (FDA), to the immediate-release 10 mg for men, and 5 mg for women, in an attempt to reduce next-day somnolence.[12] Newer extended-release formulations include the 6.25 mg for women, and 12.5 mg or 6.25 mg for men, which also cause next-day somnolence when used in higher doses.[medical citation needed] Additionally, driving the next morning is not recommended with either higher doses or the long-acting formulation.[12] While flumazenil, a GABAA–receptor antagonist, can reverse zolpidem's effects, usually supportive care is all that is recommended in overdose.[13]

Zolpidem is a nonbenzodiazepine Z drug which acts as a sedative and hypnotic.[7][14] Zolpidem is a GABAA receptor agonist of the imidazopyridine class.[7] It works by increasing GABA effects in the central nervous system by binding to GABAA receptors at the same location as benzodiazepines.[7] It generally has a half-life of two to three hours.[7] This, however, is increased in those with liver problems.[7]

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Zolpidem is labelled for short-term (usually about two to six weeks) treatment of insomnia at the lowest possible dose.[7][8] It may be used for both improving sleep onset, sleep onset latency, and staying asleep.[5]

Guidelines from NICE, the European Sleep Research Society, and the American College of Physicians recommend medication for insomnia (including possibly zolpidem) only as a second line treatment after non-pharmacological treatment options have been tried (e.g. cognitive behavioral therapy for insomnia).[9][10][11] This is based in part on a 2012 review which found that zolpidem's effectiveness is nearly as much due to psychological effects as to the medication itself.[21]

A lower-dose version (3.5 mg for men and 1.75 mg for women) is given as a tablet under the tongue and used for middle-of-the-night awakenings. It can be taken if there are at least 4 hours between the time of administration and when the person must be awake