Non-benzodiazepine hypnotics and older adults: what are we learning about zolpidem?

Zolpidem and other non-benzodiazepine (BZD) hypnotic agents have become preferred drugs to manage insomnia. They are widely used among older adults because of perceived improved safety profiles compared with traditional BZDs. Accumulating data in recent years in patients over the age of 65, however, shed light on possible safety concerns of these medications and zolpidem specifically. Recent information regarding potential for excessive blood concentrations, effects on balance and memory and fracture risk data briefly is described. Clinicians should be aware of these most recent data. Non-drug therapies, as recommended in clinical guidelines, should be fully utilized for managing insomnia. Until better studies or pharmacovigilance data become available to guide patient selection for prescribing zolpidem and other non-BZDs, judicious use of these hypnotic agents in older adults is warranted.