Temazepam is officially indicated for severe or debilitating insomnia and other severe or disabling sleep disorders. Temazepam is an hypnotic agent. The prescribing guidelines in the UK limit the prescribing of hypnotics to two-to-four weeks due to concerns of tolerance and dependence.[10] In sleep laboratory studies, temazepam significantly decreased the number of nightly awakenings[11] but has the drawback of distorting the normal sleep pattern.[12] The United States Air Force uses temazepam as one of the hypnotics approved as "no-go pills" to help aviators and special duty personnel sleep in support of mission readiness. "Ground tests" are required prior to authorization being issued to use the medication in an operational situation.[13]
In addition to treating insomnia, temazepam is also used as a pre-anaesthetic in surgery. A study conducted on adult women undergoing minor gynaecological surgery in a dose of 30 mg and compared to 10 mg of diazepam. The sedative effect of temazepam was found to be profoundly superior to that of diazepam, using both objective and subjective criteria for assessment. There was also a highly significant degree of patient acceptance of the drug. It is suggested that temazepam is a suitable drug for premedication for minor surgery.[14]
Temazepam is also a potent anticonvulsant and has been used to treat refractory epilepsies in the past. However, long term prophylactic treatment of epilepsy has considerable drawbacks. Most importantly the loss of antiepileptic effects due to tolerance which renders prolonged temazepam therapy ineffective. Temazepam also has the drawback of significant side effects such as heavy sedation, which is why benzodiazepines in general are only prescribed in the acute management of epilepsies. Temazepam has even been found to be more effective than clonazepam in treating a wide range of epileptic conditions, but long term therapy becomes ineffective with prolonged therapy and the side effects of hypotonia and strong, heavy sedation are troublesome with temazepam therapy, unlike with clonazepam therapy.[15]