CNS

Sedative-Hypnotics

CNS Medications

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Examples

zolpidem (Ambien)eszopiclone (Lunesta)ramelteon

Prefix / Suffix: Z-drugs often start with 'z-'

Physiology

Sleep-wake cycles are regulated by GABA (inhibitory) and other neurotransmitters. Enhancing GABA promotes sedation and sleep.

Mechanism of Action

Bind GABA-A receptors (similar site to benzodiazepines), enhancing inhibitory effects to induce sleep. Ramelteon acts on melatonin receptors.

Indications

  • Short-term insomnia
  • Difficulty initiating sleep

Side Effects / Adverse Effects

  • Daytime drowsiness
  • Dizziness
  • Complex sleep behaviors (sleep-walking, sleep-driving)
  • Dependence with long-term use
  • Rebound insomnia on withdrawal

Contraindications

  • Severe respiratory impairment
  • Sleep apnea (untreated)
  • Concurrent CNS depressants/alcohol

Nursing Considerations

  • Give immediately before bedtime with at least 7–8 hours available for sleep
  • Do not take with alcohol or other CNS depressants
  • Use for short-term only (typically <2–4 weeks) to avoid dependence
  • Educate about complex sleep behaviors — discontinue if they occur
  • Implement sleep hygiene measures alongside medication
  • Caution with elderly — increased fall risk

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.