Background: Zolpidem, zolpiclone, and zaleplon, also called Z drugs, are kinds of sedative-hypnotic medication prescribed for adults’ insomnia. On April 30, 2019, the US Food and Drug Administration (FDA) announced drug safety communication about severe injuries or deaths caused by complex sleep behaviors induced by using Z drugs and added black-box risk warning in the label of these drugs. Patients who experienced complex sleep behaviors after taking these drugs would be contraindicated.
Objectives: Therefore, we surveyed the patients who ever used Z drugs in our institution to evaluate the risk.
Methods: We surveyed the patients who had ever taken Z drugs from July 2012 to May 2018 in our center and identified complex sleep behaviors by ICD codes of sleepwalking, ICD9=307.46, ICD10=F51.3, F51.4, and suicide, ICD9=E950.0-E958.9. The assessment included (1) sex ratio (2) number of people in the respective group (3) mean duration of taking Z drugs (4) incidence of sleepwalking (5) incidence of suicide in the population.
Results: In total, there are 11090 patients who had ever taken Z drugs from July 2012 to May 2018 in our center. In the population, the male is 4154 (37%) and the female is 6936 (63%). There are 6366(57%), 3490(32%), and 1234(11%) cases in the group of zolpidem, zolpiclone, and zaleplon, respectively. The mean duration of taking Z drugs is 457.37 days. There is no case of sleepwalking in the population, but there is a case who commit suicide attempts (0.009%).
Conclusions: Though there was only one case featuring complex sleep behaviors as committing suicide attempts in the population (0.009%), the risk might not be ignored. Health care professionals should be aware of the adverse effect caused by Z drugs and make sure the patients under using these drugs also keep alert.
