Z-drugs, such as zolpidem and zopiclone, have been associated with sleep-related behaviors, parasomnia, abnormal thinking, disinhibition, aggressiveness, mood alterations, and anterograde amnesia. Sleep driving is one of the Z-drug-induced parasomnias reported frequently with zolpidem and often raises diagnostic challenges among clinicians due to its complex presentation and medico legal ramifications. This review focuses on the epidemiology, clinical presentation, psychopharmacology, diagnosis, laboratory tests, and forensic aspects of Z-drug-induced sleep driving. In addition, this review helps practitioners to identify and distinguish Z-drug-induced sleep driving from individuals with history of somnambulism, as this distinction is key for diagnostic clarification in medico legal cases.
Food and Drug Administration (FDA). Questions and answers: risk of next-morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist). 2013. Available at https://www.fda.gov/drugs/drugsafety/ucm334041.htm. Accessed 21 Jan 2018.