Z-Drugs and Benzodiazepines for Insomnia

<jats:p>Z-drugs are an appropriate first-line pharmacologic option for chronic insomnia — except in recent SUD. Consider benzodiazepines for severe insomnia unresponsive to multiple medication trials. When treating women with zolpidem, use lower doses. Higher morning plasma levels raise the risk of delayed reaction time and next-day accidents. Avoid Z-drugs and benzodiazepines in patients on opioids. Co-prescription substantially increases unintentional overdose risk, especially with benzodiazepines.</jats:p>