Ambien side effects??

[robysue]

The short version of the update on the Second War on Insomnia:

At the suggestion of my current sleep doc, I am trialing taking generic Ambien every night. I'm on a very low dose: 2.5 mg at bedtime. So I am cutting the tabs. I've been taking it now for about 3 1/2 weeks. I have been in touch with the sleep doc through email, but he's not had much to say other than he wants me to keep in updated.

Last night I apparently took my mask off and turned the machine off for about an 80-90 minute period during the second half of the night. (The start of this time period is about 4 hours after I took the Ambien.) I also apparently put the mask back on in my sleep at the end of this time frame because I have no memory waking up sans mask at any point during the night: But the machine was definitely turned off for almost the entire time and I don't remember an extended wake where I intentionally took my mask off. Hubby remembers a bit of "clear" snoring towards the end of this, but I was apparently not facing him and he didn't think to determine whether or not I had my mask on.

In three years of PAPing, I have had exactly three occurrences of taking my mask off and putting the mask back on in my sleep. And all three were on nights when I took Ambien. It happened once during the First War on Insomnia on the first night I took Ambien. During the First War, I was only taking Ambien on an "as needed basis" and it only happened the one time. The second time it happened was my second night of Ambien during the current trial. (I did report it.) I plan on contacting the sleep doctor again today through email to report the latest occurrence.

My questions to the group are these:

1) When people have problems with odd ball sleep behaviors with Ambien, are they likely to be intermittent? Or are they more likely to be night after night?

2) Is the frequency of this kind of Ambien-influenced behavior likely to remain intermittent, or will it grow over time?

3) In the course of my Adventures in Hosehead Land, I've taken Ambien maybe 35-40 times. I've taken the mask off for extended periods on three of those 35-40 nights. That's about 7-8% of the nights I've taken Ambien. Is that a high enough percentage of nights with strange (Ambien-influenced?) sleep behavior for me to be worried about?

Finally, for what it's worth: On Ambien I wake up feeling rather drugged and hung over and it takes an extremely long time to just start functioning. But on the plus side, the Ambien is taking the edge off the sensory overload when I put the mask on and hence it is helping to stabilize my bedtimes, which in turn is good for dealing with the circadian rhythm problem that adds to my PAPing problems. And it seems to guarantee that I get one really clean, good sleep cycle at the beginning of the night. The drugged feeling has been reported to the sleep doc and he says to be careful in the morning and not do any driving until I'm sure the Ambien has worn completely off. So hubby is driving me to work most days.

[RandyJ]

I took regular Ambien 10mg dose (for about 8 months, 11 years ago) and never had any issues with doing something during the night that I could not recall in the morning, though I think I have read that these instances are more common with women than with men. (Reports were mostly of women doing things like binge eating in the kitchen and returning to bed with no memory of the event.)

When I awakened in the morning, I felt almost normal. Sometimes a bit foggy for about 10-15 mins. I would get about 7-8 hours sleep so I was thinking that by the time I woke up, it was mostly worn off. At the time, the CR was not yet available.

[bryansong]

You wrote you were taking generic Ambien, is that Zolpidem?

I currently take Zolpidem at 5 to 10mg doses. I break the pill in half for the 5 but that usually doesn't work.

A few years ago I was taking Ambien and not the generic but it made me get up in the night and eat.
I also tried Ambien CR (controled release) to help me through the night because I was waking up and
couldn't get back to sleep. The CR worked but I found I was losing my memory so I quit taking that
after a month.

I think the point I am trying to get to is for me the generic Ambiden Zolpidem and the regular Ambien
were nothing alike in how they affected me. I haven't had any issue of removing my mask in the night or
doing anything weird.

I would like to try the Ambien again but the cost is prohibitive. What's with the drug companies and their prices anyway?
They must think we are all rich.

Bryan

[robysue]

I'm taking zolpidem (generic Ambien). I'm using the regular stuff not the CR version.

I'm cutting 5mg tabs in half, so I'm taking 2.5 mg.

[dieselgal]

I find that I do better on extended release Ambien or Generic Zolpidem 12.5 ER than on regular Ambien. I sleep better and deeper because of the gradual release of the medication I guess. A small dose like you take wouldn't even affect me so all people are different.
As far a I know I have only had one event where I did anything unusual while taking ambien but the truth is that it might happen often and we just don't know it and our spouses don't mention it. Actually if they are asleep too they can't watch us!However, the same could be said about nights without ambien. My little brother was a sleep walker and that was without drugs!
Regular ambien/zolpidem tends to give me a bit of a headache and I also feel more sluggish the next day. For some reason extended release seems better in that area. But one thing I did notice is that when I used ambien everyday for an extended period I tended to feel more off balance and sometimes dizzy. For that reason I now only take it when I am just really desperate for sleep. I don't sleep well ever but about twice a week I am forced to try for at least 5 hours and that takes help for me.

[Bobshouse]

Do not take ambien or zolpidem and then drink any alcohol. Alcohol will give you the "lost memory" that a few posts above mention. Any alcohol will effect you, even if you drink a cap of Nyquil before bed to clear your nasal congestion.

[bryansong]

Do not take ambien or zolpidem and then drink any alcohol. Alcohol will give you the "lost memory" that a few posts above mention. Any alcohol will effect you, even if you drink a cap of Nyquil before bed to clear your nasal congestion.

I quit drinking any alcohol about 12 years ago and if my memory serves me correct the ambiem memory loss has been since then. I hope I'm remembering that right.

What were we talking about?

[robysue]

Re: Alcohol
I'm always very careful with alcohol and (any) drugs. I'm exceptionally small (110 lbs and 5' 1") and I do know how alcohol tends to affect me. (Yes, I have been drunk--as in really drunk not just a bit tipsy---twice in college. Both times lead to a killer, monstrously bad hangover headache. )

Since being on the 2.5 mg of generic Ambien, I've had a total of maybe 2 beers. Last one was about 10 days ago when we went out to eat with a good friend at a local bar/restaurant known for both its fantastic fish fry and its long list of high quality beers on tap. That night, there was a high spike in the hourly AHI (not uncommon when I have a beer with dinner), but nothing else of note in the data.

[Julie]

'Exceptionally'? I don't consider 5'1 to be 'exceptional'.

[RandyJ]

I'm exceptionally small (110 lbs and 5' 1")

Have you considered that 2.5mg may be too much for your size/weight? It may not be feasible to break up tablets any smaller than you are currently doing, but I wonder how you would do with less than 2.5mg, perhaps you might get the same benefit at bedtime without the morning after effects... ?

[ClayL]

For what it's worth. Our primary care doctor rarely prescribes Ambien because he says it can cause sleepwalking episodes.
Our doctor said there are studies in the literature that confirm it and that he came home from an emergency call at about 3:00am and saw his neighbor sleeping on his front lawn. He had no idea how he got there. He was taking Ambien at the time.

My mother in law who does not drink had at least one sleepwalking episode while taking it. One of them involved getting out of bed, going to the kitchen, getting and drinking a glass of milk then leaving the milk carton and glass on the counter and going back to bed. She could not figure out how the milk carton and empty glass got there.

My wife told her to ask her doctor about the possibility of Ambien being at fault. He said yes and prescribed something else.

Obviously it doesn't affect everyone that way but it is something to be aware of.

[robysue]

I'm exceptionally small (110 lbs and 5' 1")

Have you considered that 2.5mg may be too much for your size/weight? It may not be feasible to break up tablets any smaller than you are currently doing, but I wonder how you would do with less than 2.5mg, perhaps you might get the same benefit at bedtime without the morning after effects... ?

That's exactly what I and my sleep doc think. But it's hard to break the tabs any smaller than I'm already cutting them.

The Ambien prescription is supposed to help address my current insomnia by helping address the (long standing) circadian rhythm problem that I have since the data from several sleep tests and the actigraph test seem to indicate that much of my insomnia is related to my circadian rhythm. One way my circadian rhythm stuff creates serious problems is through additional long wakes and restlessness if I go to bed too soon.

This summer (before starting the Ambien) I was pretty much hitting the sack sometime between 3:00 and 4:30 most nights, which is when I get sleepy on my own. Since I was not teaching, this wasn't much of an issue: I'd go to bed between 3:00 and 4:30 and I'd sleep until I was ready wake up (without an alarm clock) sometime between 9:30 and 10:30. This sleep from 3:00-4:30 AM to 9:30-11:30 AM sleep schedule has been pretty typical of my summers for a long time, including both the summer of 2012 and 2013. But unlike the summer of 2012, this summer I was never really fully rested when I woke up and I'd tire very easily in the middle of the afternoon and around supper time, but by 10pm I was becoming more and more alert. (I am a night owl.) But this summer whenever I would simply try to go to bed earlier---as in "be in bed by around 1:30-2:30 AM", I'd have one or two major wakes and/or very restless periods of lots of tossing and turning that would usually kick in sometime around 3:30 to 4:30 in the morning and I'd wake up feeling even worse than usual. I'd also have more problems focusing during the daytime and I'd get excessively sleepy after lunch, but I'd still find myself waking up by 9:00pm or 10:00pm at night.

After two additional sleep tests were done this summer, the sleep doc had me wear an actigraph wrist band for a couple of weeks. During that time I basically kept to my crazy 3:00-4:30 AM bedtime and except for one night, I'd say the nights that the actigraph recorded data were pretty typical of the way I was sleeping for the entire summer. The actigraph test's data indicated there were an average of 9.5 full wakes lasting > 5 minutes each on an average night.

Hence the doc's suggestion to try a very small dose of Ambien at "bedtime" where "bedtime" is supposed to be more like 1:30 instead of my usual (circadian rhythm driven bedtime of 3:00-4:30). And both the doc and I are hoping that the lightbox and the ambien-stabilized bedtimes will start to positively affect the circadian rhythm problem: We hope that I might soon start feeling sleepy enough to successfully get to bed earlier than I am right now and still manage to sleep more or less through the night without any additional awakenings and get up in time for me to be fully functional for my 10:00 Wednesday class and my 11:00 classes the other four days of the week.

With the help of the Ambien, I've been able to get the bedtime sort of stabilized at between 1:30 and 2:00 and not have too many problems with the nasty wakes I had this summer when I would try to go to bed that early; I'm still waking and restless in the second half of the night, but the wakes are not as long and the restlessness is not as great. So once I finally wake up and shake off the drugged-by-Ambien feeling I'm feeling about as well rested as I felt on my natural circadian cycle during the summer. Undoubtedly part of the "drugged" feeling in the morning is that I'm sensitive to the Ambien, but the problem is exacerbated by the fact that I'm only getting about 6-6.5 hours of time in bed most nights. My own goal is once I've got the bedtime firmly established at 1:30-2:00, I'll move bedtime back to 1:00-1:30 without changing the wake up time. That will give me closer to 7 hours of "time in bed." I'm not sure, however, that I'll ever be able to increase "time in bed" to 8 hours since I've never really slept much longer than 6.5-7 hours when I'm left on my own.

As an interesting side note: On the few nights where I have taken the Ambien as early as 1:00-1:30, I've wound up waking up at 7:00 or 7:30 with a profound sense of "swimming" and I have had an extremely difficult time with both getting back to sleep AND with just getting out of bed and starting the day due to the disorientation triggered by the "swimming", which feels similar to, but is more disorienting than, my usual bouts of severe vertigo since the "swimming" is disorienting in both a mental sense and a balance sense; whereas the severe vertigo is only disorienting in a balance sense. Taking the Ambien closer to 2:00 doesn't seem to cause as much of this problem and even when the "swimming" is bad at 8:30, I can still pull myself out of bed and get down the stairs and eat breakfast in front of the lightbox while waking for the brain to really wake up.

[49er]

Hi RobySue,

You could look into getting your prescription made at a compound pharmacy. You may or may not know but they made the doses that you can't obtain at your local regular drug store.

The downside is that your insurance policy may not cover it and if they do, the coverage might not be the greatest. But it is worth looking into in my opinion, particularly if you think a lower dose might be really beneficial.

As an FYI, when I needed to reduce Wellbutrin XL several years ago, I went this route because I couldn't reduce it the very slow way I wanted with regular doses at the local drug store. My psychiatrist thought I was nuts:) but at least he cooperated with what I wanted to do. And it worked great.

49er

I'm exceptionally small (110 lbs and 5' 1")

Have you considered that 2.5mg may be too much for your size/weight? It may not be feasible to break up tablets any smaller than you are currently doing, but I wonder how you would do with less than 2.5mg, perhaps you might get the same benefit at bedtime without the morning after effects... ?

That's exactly what I and my sleep doc think. But it's hard to break the tabs any smaller than I'm already cutting them.

The Ambien prescription is supposed to help address my current insomnia by helping address the (long standing) circadian rhythm problem that I have since the data from several sleep tests and the actigraph test seem to indicate that much of my insomnia is related to my circadian rhythm. One way my circadian rhythm stuff creates serious problems is through additional long wakes and restlessness if I go to bed too soon.

This summer (before starting the Ambien) I was pretty much hitting the sack sometime between 3:00 and 4:30 most nights, which is when I get sleepy on my own. Since I was not teaching, this wasn't much of an issue: I'd go to bed between 3:00 and 4:30 and I'd sleep until I was ready wake up (without an alarm clock) sometime between 9:30 and 10:30. This sleep from 3:00-4:30 AM to 9:30-11:30 AM sleep schedule has been pretty typical of my summers for a long time, including both the summer of 2012 and 2013. But unlike the summer of 2012, this summer I was never really fully rested when I woke up and I'd tire very easily in the middle of the afternoon and around supper time, but by 10pm I was becoming more and more alert. (I am a night owl.) But this summer whenever I would simply try to go to bed earlier---as in "be in bed by around 1:30-2:30 AM", I'd have one or two major wakes and/or very restless periods of lots of tossing and turning that would usually kick in sometime around 3:30 to 4:30 in the morning and I'd wake up feeling even worse than usual. I'd also have more problems focusing during the daytime and I'd get excessively sleepy after lunch, but I'd still find myself waking up by 9:00pm or 10:00pm at night.

After two additional sleep tests were done this summer, the sleep doc had me wear an actigraph wrist band for a couple of weeks. During that time I basically kept to my crazy 3:00-4:30 AM bedtime and except for one night, I'd say the nights that the actigraph recorded data were pretty typical of the way I was sleeping for the entire summer. The actigraph test's data indicated there were an average of 9.5 full wakes lasting > 5 minutes each on an average night.

Hence the doc's suggestion to try a very small dose of Ambien at "bedtime" where "bedtime" is supposed to be more like 1:30 instead of my usual (circadian rhythm driven bedtime of 3:00-4:30). And both the doc and I are hoping that the lightbox and the ambien-stabilized bedtimes will start to positively affect the circadian rhythm problem: We hope that I might soon start feeling sleepy enough to successfully get to bed earlier than I am right now and still manage to sleep more or less through the night without any additional awakenings and get up in time for me to be fully functional for my 10:00 Wednesday class and my 11:00 classes the other four days of the week.

With the help of the Ambien, I've been able to get the bedtime sort of stabilized at between 1:30 and 2:00 and not have too many problems with the nasty wakes I had this summer when I would try to go to bed that early; I'm still waking and restless in the second half of the night, but the wakes are not as long and the restlessness is not as great. So once I finally wake up and shake off the drugged-by-Ambien feeling I'm feeling about as well rested as I felt on my natural circadian cycle during the summer. Undoubtedly part of the "drugged" feeling in the morning is that I'm sensitive to the Ambien, but the problem is exacerbated by the fact that I'm only getting about 6-6.5 hours of time in bed most nights. My own goal is once I've got the bedtime firmly established at 1:30-2:00, I'll move bedtime back to 1:00-1:30 without changing the wake up time. That will give me closer to 7 hours of "time in bed." I'm not sure, however, that I'll ever be able to increase "time in bed" to 8 hours since I've never really slept much longer than 6.5-7 hours when I'm left on my own.

As an interesting side note: On the few nights where I have taken the Ambien as early as 1:00-1:30, I've wound up waking up at 7:00 or 7:30 with a profound sense of "swimming" and I have had an extremely difficult time with both getting back to sleep AND with just getting out of bed and starting the day due to the disorientation triggered by the "swimming", which feels similar to, but is more disorienting than, my usual bouts of severe vertigo since the "swimming" is disorienting in both a mental sense and a balance sense; whereas the severe vertigo is only disorienting in a balance sense. Taking the Ambien closer to 2:00 doesn't seem to cause as much of this problem and even when the "swimming" is bad at 8:30, I can still pull myself out of bed and get down the stairs and eat breakfast in front of the lightbox while waking for the brain to really wake up.

[hueyville]

I have been using Ambien regular ever since 2nd week of cpap therapy. Before diagnosis took it on an as need basis sporatically. Early on I had two episodes of going off the reservation but minor. 1st time I went to kitchen and ate my 1/2 gallon of vanilla ice cream and my wifes bucket of butter pecan. I dont like butter pecan and do not remember so must have been the Ambien. 2nd incident wife said I talked in sleep for about 20 minutes. Now have taken almost every night for 3 years with zero issue. I take a 5 mv at bedtime and a 2nd if I wake up again more than 3 hours before alarm time. It is a wonder drug for me as able to sleep all night without pain meds to manage back and neck pain. Cut your dose and give body time to adjust.

[robysue]

You could look into getting your prescription made at a compound pharmacy. You may or may not know but they made the doses that you can't obtain at your local regular drug store.

This is an idea that I may run by my sleep doc. There are a couple of compounding pharmacies in the northern half of the Buffalo metro area, so it may be worth a try.

I Cut your dose and give body time to adjust.

Without using a compounding pharmacy, it seems pretty difficult to cut my dose any further by chopping pills by hand or with a pill slicer ...