How does zolpidem wake coma patients?

Question

There have been many reports of zolpidem  based drugs bringing patients out of coma or unresponsive state.

There seems to be no explanation of why this happens. What are the possible reasons?

Answer 1

This is unknown so we can only speculate. zolpidem is GABA agonist, i.e. immitates action of GABA, an inhibitory neurotransmitter. It is conceivable that in some cases vegetative or semi-vegetative state may be due to excessive activity of neural pathways that actively suppress consciousness. In so, to activate consciousness, such consciousness-suppressing neural pathways need to be inhibited. So, perhaps  zolpidem inhibits such pathways, resulting in lifting of their suppressive effect on the pathways that maintain consciousness.