Sleep Care

Is Ambien Worth the Extra Sleep?

As a quick solution for sleepless nights, sleeping pills have been a growing business: in 2011, Americans filled over 60 million prescriptions for sleeping pills, according to health care service company IMS health. In evaluating data from the National Health and Nutrition Examination Survey (focusing on the years 2005-2010), researchers at the Centers for Disease Control and Prevention found that about 1 in 25 Americans use sleeping pills to help them sleep, and they tend to be older (over the age of 50), female, and have higher levels of education. The market has grown over the years to include a variety of brand-name pills, including Ambien, Lunesta, Rozerem, and Sonata. Sometimes benzodiazepines (such as Restoril or Xanax) or anti-depressants (Trazodone, Remeron) can be prescribed to promote sleep. Staring at the ClockAmong these, Ambien (generic name: zolpidem) is perhaps the most widely used, with over 43 million prescriptions written in 2012. Its original form was designed to help people fall asleep, although it often led to them waking up during the night as the medication wore off. This led to Ambien CR (controlled-release) being created, which still promotes sleep within 15-30 minutes—but the steady release of the drug ensures sleep throughout the night. Related to Ambien is Zolpimist, a prescription oral spray that is approved by the FDA for short-term treatment of insomnia related to sleep-onset problems. Zolpimist contains Ambien’s active ingredient, zolpidem tartrate. Concerns about side effects Despite its popularity, there have been concerns raised about Ambien due to its side effects. Some common ones: headaches, grogginess, a “hangover” feeling, or nausea, may be unpleasant but tolerable. Other effects however, such as short-term memory loss or drowsiness while driving, are more serious. For all the amusing and relatively harmless stories of Ambien effects, hallucinations, nighttime snacking, mild sleepwalking, there are also significantly more dangerous ones, such crashing a car while sleep driving. These effects may be explained by the way Ambien works on the brain: attaching to GABA-A receptors and lowering brain activity levels (to promote sleep). This means that if a person is roused from sleep, it is possible for their body to be awake and active, but their brain to still be in a relatively unconscious state. An additional concern with Ambien is building up a tolerance to its sleep-inducing effect, requiring that greater amounts of the drug be taken to achieve the same results. Gender is also a factor, as studies have shown that women clear the drug from their systems slower than men do. This resulted in the FDA

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issuing dosage guidelines that lowered the suggested dosages of Ambien for women, as compared to men (although physicians

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are encouraged to consider lower dosages for men as well). Is Ambien worth it? So, is Ambien worth taking? Ultimately, it depends upon a person’s medical history, current conditions, and lifestyle. For example, Ambien should not be considered by individuals who do not have the recommended 7-8 hours of

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time available for sleep, as some effects of the drug may remain if awakening too early. A good place to start in evaluating if Ambien is worth the risks is a consultation with a doctor or sleep specialist. In addition to the prescription necessary for Ambien, they might be able to discuss some other potential solutions for insomnia, such as improved sleep hygiene habits or lifestyle changes.

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