A case of zaleplon-induced amnestic sleep-related eating disorder.

To the Editor: Sleep-related eating disorder (SRED) is a type of sleep disorder in which the individual is amnestic completely or partially to the eating episode, which occurs during NREM sleep. Several medications have been implicated in unusual sleep behaviors, and the US Food and Drug Administration (FDA) has recommended revised labeling on these medications. Zolpidem has the most published data, and patients have engaged in many complex behaviors after taking this product, including sleepeating, sleepwalking, sleep-driving, and sleep-sex. In discussing the management of hypnotic-induced complex behaviors, some have postulated that switching to another nonbenzodiazepine receptor agonist (NBRA) or reducing the dose of the offending agent may decrease the possibility of these behaviors. The following case suggests that switching to another NBRA does not necessarily resolve SRED. This patient had a new onset of amnestic SRED with high-dose zolpidem that stopped when treatment was switched to zaleplon. The SRED recurred 25 months later while the patient was receiving a maximum FDArecommended dose of zaleplon, thus highlighting the importance of dose in the occurrence of NBRA-induced complex behaviors. This is the first reported case of zaleplon-induced complex sleep behavior occurring at a recommended FDA dose.