What You Need to Know About Zolpidem Side Effects

Zolpidem — sold as Ambien, Ambien CR, Edluar, and Zolpimist — is one of the most commonly prescribed sleep medications in the United States. It works well for most people, but like all medications, it comes with potential side effects. Some are mild and temporary. Others are serious and require immediate medical attention.

This guide covers the most common and serious side effects of Zolpidem, who's at higher risk, and when you should call your doctor.

What Is Zolpidem?

Zolpidem is a non-benzodiazepine sedative-hypnotic (sometimes called a "Z-drug") prescribed for the short-term treatment of insomnia. It works by enhancing the effects of GABA, a calming brain chemical, to help you fall asleep faster. To learn more about how Zolpidem works, see our detailed explainer.

Zolpidem is a Schedule IV controlled substance, meaning it has a lower potential for abuse than some other sleep aids — but side effects can still occur, especially if it's not taken correctly.

Common Side Effects

These side effects are reported frequently in clinical trials and are usually mild. They often improve after your body adjusts to the medication over the first few days.

• Drowsiness and next-day grogginess — The most common complaint. You may feel sleepy or "foggy" the morning after taking Zolpidem, especially at higher doses. Women are more prone to this because they metabolize the drug more slowly.
• Dizziness — May occur when you get up during the night or first thing in the morning.
• Headache — Reported in clinical trials at rates similar to placebo in some studies.
• Diarrhea — A less common but documented gastrointestinal side effect.
• "Drugged" feeling — Some people describe feeling sedated or not fully alert, even after a full night's sleep.
• Nausea — Usually mild and often resolves within the first week.
• Lethargy or fatigue — May overlap with next-day drowsiness.

If any of these side effects are severe or don't go away after a week, talk to your doctor. A dose adjustment — or switching to a different formulation — may help.

Serious Side Effects

These side effects are less common but can be dangerous. Contact your doctor right away — or call 911 — if you experience any of the following.

Complex Sleep Behaviors (Boxed Warning)

This is the most important safety warning for Zolpidem. The FDA requires a boxed warning — the most serious type of safety alert — about complex sleep behaviors. These include:

• Sleepwalking
• Sleep-driving (getting behind the wheel while not fully awake)
• Making phone calls, preparing food, or having conversations you don't remember

These behaviors can happen after the very first dose. People who experience them typically have no memory of what they did. In rare cases, complex sleep behaviors have resulted in serious injuries and death.

If you or someone around you notices any of these behaviors, stop taking Zolpidem and call your doctor immediately. You should not take Zolpidem again if you've experienced a complex sleep behavior.

Severe Allergic Reactions

Though rare, some people experience anaphylaxis or angioedema (severe swelling of the face, tongue, or throat). Seek emergency medical care if you have trouble breathing or swelling after taking Zolpidem.

Respiratory Depression

Zolpidem can slow your breathing, especially if combined with opioids, benzodiazepines, or alcohol. This is potentially life-threatening.

Suicidal Thoughts

In some patients — particularly those with depression — Zolpidem may worsen suicidal ideation. If you notice changes in mood or thoughts of self-harm, contact your doctor or call 988 (Suicide & Crisis Lifeline) immediately.

Worsening Depression

Zolpidem may worsen depression in people who already have it. Let your doctor know if you experience increased sadness, hopelessness, or withdrawal from activities.

Withdrawal Symptoms

If you've been taking Zolpidem regularly and stop suddenly, you may experience rebound insomnia, anxiety, muscle cramps, or tremors. Always taper off under your doctor's guidance.

Side Effects in Specific Populations

Women

The FDA specifically recommends lower doses for women (5 mg immediate-release, 6.25 mg extended-release) because women clear Zolpidem from their bodies more slowly than men. This means higher blood levels the next morning, leading to greater risk of next-day impairment — including impaired driving.

Older Adults

Seniors are more sensitive to Zolpidem's sedative effects and are at higher risk for falls, confusion, and cognitive impairment. The recommended starting dose is 5 mg. The American Geriatrics Society's Beers Criteria lists Zolpidem as a medication to avoid in older adults when possible.

People with Liver Problems

Zolpidem is processed by the liver. If you have hepatic impairment, the drug stays in your system longer, increasing the risk of side effects. Your doctor should prescribe a lower dose (5 mg) and monitor you closely. Zolpidem is contraindicated in severe liver disease.

Pregnant or Breastfeeding Women

Zolpidem is classified as Pregnancy Category C — meaning animal studies have shown risk and there aren't enough human studies. It should generally be avoided during pregnancy. Zolpidem does pass into breast milk, so talk to your doctor if you're breastfeeding.

How to Manage Common Side Effects

Here are practical steps to reduce Zolpidem side effects:

• Take the lowest effective dose. Start at 5 mg (or 6.25 mg for extended-release). Don't increase your dose without talking to your doctor.
• Allow 7–8 hours for sleep. Taking Zolpidem when you can't get a full night's rest increases next-day drowsiness.
• Take it on an empty stomach. Food delays absorption, which can shift the sedative effects later into the night or morning.
• Avoid alcohol completely. Even one drink can amplify Zolpidem's sedative effects and increase the risk of complex sleep behaviors.
• Don't combine with other sedating medications without your doctor's knowledge.
• Get up slowly. If you need to use the bathroom at night, sit on the edge of the bed for a moment before standing to avoid falls from dizziness.

Final Thoughts

Most people tolerate Zolpidem well when they take it as directed. The most common side effects — drowsiness, dizziness, and headache — are usually manageable. But the risk of complex sleep behaviors is real and serious. Pay attention to how the medication affects you, and don't hesitate to call your doctor if something doesn't feel right.

If you're looking for more information about this medication, read our guides on what Zolpidem is, how it works, and drug interactions to watch for. And if you need help finding Zolpidem at a pharmacy near you, Medfinder can help.