Dados do Trabalho

Título

Case Report: Non-REM Parasomnia Secondary to the Use of Non-Benzodiazepine Benzodiazepine Receptor Agonists

Introdução

Disorders of arousal from non-rapid eye movement (NREM) sleep are parasomnias that include confusional arousals, sleepwalking, sleep terrors, and their variants. They are classified as distinct entities, but in reality, they represent a spectrum of sleep-related behaviors that occur as a result of incomplete transition out of deep NREM sleep. While disorders of arousal typically present in childhood, they may continue into adulthood, remit and recur in adulthood, or present de novo in adults. Disorders of arousal are an important cause of sleep-related injury in adults.

Objetivo

Discuss the Impact of Hypnotic Medications When Misused

Métodos

Male, 78. The companion (son) reports that the patient experienced a sudden behavioral change during the night/sleep. He began packing his bags, believing he was relocating to his in-laws' city. The patient himself could not report the occurrence. The patient has experienced other episodes (approximately eight times in one year) of mental confusion, not retaining memory of the episodes, all occurring at night and related to awakening. Prior to these changes, the patient had difficulties with the correct use of his medications, and his son discovered that there had been an unintentional time switch, with levothyroxine being taken at night before bedtime. The patient began experiencing insomnia and was prescribed Zolpidem, which coincided with these episodes of confusional alteration. The discontinuation of the medication led to the resolution of the condition.

Resultados

A variety of medications and substances can precipitate events, including psychotropic medications (eg, anticholinergics, antipsychotics) and sedative-hypnotic agents, most notably the nonbenzodiazepine benzodiazepine receptor agonists (eg, zolpidem, eszopiclone). In the setting of nonbenzodiazepines such as zolpidem, behaviors are often prolonged and can include eating, sexual activity, and driving while not fully awake. Rare serious injuries including death have been reported via mechanisms such as accidental overdose, motor vehicle crash, and drowning. Higher dose or drug-drug interactions have been implicated in some, but not all, reports.

Conclusões

Misuse of hypnotic medications can lead to serious complications for both patients and their families. We must consider the real necessity of using these medications, specially as a bridge to therapies with fewer deleterious effects.

Palavras -chave

Zolpidem
Non-REM Parasomnia
Misuse