In sleep laboratory studies, temazepam significantly decreased the number of nightly awakenings, but has the drawback of distorting the normal sleep pattern. It is officially indicated for severe insomnia and other severe or disabling sleep disorders. The prescribing guidelines in the UK limit the prescribing of hypnotics to two to four weeks due to concerns of tolerance and dependence.
The United States Air Force uses temazepam as one of the hypnotics approved as a “no-go pill” to help aviators and special-duty personnel sleep in support of mission readiness. “Ground tests” are necessary prior to required authorization being issued to use the medication in an operational situation, and a 12-hour restriction is imposed on subsequent flight operation. The other hypnotics used as “no-go pills” are zaleplon and zolpidem, which have shorter mandatory recovery periods.
Use of temazepam should be avoided, when possible, in individuals with these conditions:
- Ataxia (gross lack of coordination of muscle movements)
- Severe hypoventilation
- Acute narrow-angle glaucoma
- Severe hepatic deficiencies (hepatitis and liver cirrhosis decrease elimination by a factor of two)
- Severe renal deficiencies (e.g. patients on dialysis)
- Sleep apnea
- Severe depression, particularly when accompanied by suicidal tendencies
- Acute intoxication with alcohol, narcotics, or other psychoactive substances
- Myasthenia gravis (autoimmune disorder causing muscle weakness)
- Hypersensitivity or allergy to any drug in the benzodiazepine class