A sleeping pill awakens a patient who has been sleeping for eight years.

at the age of 29, Richard (Richard) choked on a piece of meat and was admitted to the hospital because of asphyxiation and lack of oxygen.

he survived the rescue, but the hypoxia lasted too long, leaving severe brain damage that could not be cured. From then on, Richard entered a state of "motionless silence" (akinetic mutism): he regained consciousness, but he was unable to speak, and it was difficult for him to move his body to respond to the outside world.

Richard's condition has not improved for the next eight years. But after taking a dose of medicine, a miracle suddenly happened: 20 minutes later, he was able to talk. Richard not only talked to the nurse about how to operate the wheelchair, spoke to his father on the phone, and even asked if he could order fast food. At the same time, his athletic ability has been greatly improved, and he can even walk a short distance with the help of the staff.

however, the miraculous effect was fleeting: two hours after taking the medicine, Richard gradually returned to his usual inability to speak and exercise on his own.

what created this short-lived "miracle" was a sleeping pill.

patients with brain injury who have been silent for a long time, Richard Hisse Arnts et al

those awakened by sleeping pills

this sleeping pill is called zolpidem, and people who suffer from insomnia may be familiar with its trade name "Snox".

usually, the effect of a sleeping pill should be to help people fall into a deep sleep. But in addition to the sedative effect, zolpidem has a special effect that seems counterintuitive-sometimes it "wakes" patients with brain damage, resulting in a temporary but significant improvement in neurological function.

this magical recovery effect has occurred in several cases before Richard. For example, according to a medical report published in 2000, a man named Louis Vyorn (Louis Viljoen) had been in a vegetative state after a car accident, but after accidental zolpidem sedation treatment, he regained consciousness and said hello to his mother [1]. In various cases, zolpidem has shown magical effects on a variety of neuropathy, including Parkinson's disease, stroke, traumatic brain injury and so on.

Zolpidem, a fast-acting short-acting sleeping pill | Entheta/Wikipedia

fleeting

this unique effect is amazing, but at the same time its "magic" is very limited. This improvement occurs only in a small number of patients and is usually fleeting.

in Richard's case, after taking a dose of 10mg zolpidem (the dose is equivalent to a sleeping pill), the best time is only a short period of 30-60 minutes. Not only that, continuous medication will also make the effect weaken rapidly within a few days, and the "awakening time" of each medication becomes shorter and shorter. If you want to get the drug back to its best condition, you need to stop taking the drug for 2-3 weeks first. As a result, Richard's zolpidem treatment can only be used when there is a special need-such as when family members come to visit.

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New clues

although the life of a few patients has been improved to some extent, the recovery effect of zolpidem is still not satisfactory, and its rare and short-term effect can hardly be called a "treatment".

however, this phenomenon does bring new clues that may help researchers discover the nature behind various neurological abnormalities and lead to new treatments. At present, it is not clear exactly how the "awakening effect" of the sleeping pill occurs, but research is under way. In a recently published study, people recorded the changes of electroencephalogram (EEG) and magnetoencephalogram (Meg) before and after Richard's medication. The researchers speculate that zolpidem may suppress some abnormally increased brain functional connections in the short term, allowing normal neural activity to proceed smoothly.

maybe in the future, better medication will allow Richard enough time to eat his favorite fast food.

this is a case report I saw before, and it was interesting to write about it. Zolpidem also produces some rather strange side effects when used as sedative and hypnotic agents, including hallucinations and various sleepwalking behaviors. As for its various functions, the mechanism behind it is still not completely clear. Sometimes I think that psychotropic drugs are probably the real magic in this world.