A Case Study of Parasomnia with Concurrent Insomnia and Zolpidem Sensitivity

A 42-year-old male patient presenting to sleep clinic with 122-year history of sleep onset insomnia and soliloquy was studied. Following assessment, the patient was referred for CBTi therapy intervention. The all night polysomnogram did not capture the soliloquy but 3-4 episodes per week and more in times of stress were confirmed by the patient’s bed partner. Sleep log data indicated a reduction in insomnia by week six. Exposure therapy sessions were incorporated following two extreme stress conditions followed by repeated soliloquy episodes with increased wakefulness with an increase in the prescribed zolpidem prescription from 5mg HS to 10 mg HS