Zaleplon
Zaleplon is a licensed pyrazolopyrimidine hypnotic (Sonata) with a very short half-life, used for sleep-onset insomnia. Its brief duration limits next-day sedation and even permits middle-of-the-night dosing. It still carries the Z-drug risks of dependence and complex sleep behaviours.
01 Overview
Zaleplon, marketed as Sonata, is a short-acting Z-drug indicated for difficulty falling asleep. Its very short half-life means it clears quickly, so it produces little next-morning impairment and can, in some circumstances, be taken during the night provided several hours remain before waking.
It acts at the GABA-A benzodiazepine site with alpha-1 preference. While its brevity reduces daytime carryover, it shares the class liabilities of dependence, rebound insomnia and complex sleep behaviours such as sleep-walking with amnesia.
02 Mechanism
Positive allosteric modulator at the GABA-A benzodiazepine site (pyrazolopyrimidine) with alpha-1 subunit preference; ultra-short duration of action.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Therapeutic (adult) | 5–10 mg/day | Oral | At bedtime with at least 4 hours of sleep remaining; 5 mg in the elderly or hepatic impairment. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Reduced sleep latencyFalls asleep faster, shown in controlled trials. | Clinical | ||
| Minimal next-day carryoverShort half-life limits residual morning sedation compared with other hypnotics. | Clinical | ||
| SedationBrief CNS depression to initiate sleep. | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Dependence and rebound insomniaTolerance and dependence with continued use; rebound insomnia on stopping. | Moderate | Common with prolonged use | Clinical | |
| Complex sleep behavioursSleep-walking and related behaviours with amnesia, part of the Z-drug class warning. | Severe | Rare | Observational | |
| Additive respiratory depressionDangerous with opioids or alcohol. | Life-threatening | High risk in combination | Clinical |