Ambien
I've never taken the sleeping pill Ambien, but I see the commercials a lot. Actually, I see the commercials for Ambien CR a lot, which they only came up with because the original Ambien was going off patent (ask my pharmacist wife). My point, though, is that all the commercials say to only take Ambien if you have eight hours to devote to sleep. Well, what if you don't have eight hours to devote to sleep? Why not make a six-hour or four-hour sleep aid? I don't really understand how it's supposed to work for someone who's been prescribed Ambien, anyway --- if I'm lying in bed and can't get to sleep, then almost by definition it's less than eight hours before I have to wake up. Does anybody have any experience with this and know how it's supposed to work?
posted by Adam Villani @ 10/05/2007 02:38:00 AM
6 comments
6 Comments:
You should have asked on Sunday -- as you might guess, I am a font of knowledge WRT sleep medication.
Ambien (non-CR formulation) is a 4-8 hour sleep aid. Which is to say that from person to person, it will knock you out for between four and eight hours.
However, IME (and my doctor corroborates this) once you've determined what the duration is for you, you can reliably count on Ambien to hit that target time after time, within probably 15 minutes or less.
So, the first few times you take it, you make sure you have lots of time to sleep in. Then, you know how long it will last. Compare this to older sleep aids which are highly variable in their effectiveness (20 - 90 minutes before they work, 4 - 12 hours of sleep).
If you're chronically insomniac, once you know the Ambien's duration, you know what the "cutoff hour" is, that is, you know how late to keep trying to fall asleep before you give up and take a pill. Being able to predict accurately the timing for dosing yourself is incredibly useful.
Ambien CR is (in addition to creating another patentable med for the company) designed to give you smaller doses over time, rather than a large dose all at once. The theory is that this will help people who need help both falling asleep and staying asleep. The "CR" apparently stands for "controlled release." According to my doctor (and my experience bears this out), most people don't need this different formulation because the standard Zolpidem formulation knocks them out for long enough. However, for some people, standard Zolpidem only puts them to sleep for four hours. There's a "you're awake now" feature after the Zolpidem wears off that gives you that "pretty much awake now" feeling (but not strung-out) that if you regularly only got four hours of sleep, even if it was good healthy sleep, could become problematic.
Oh, and for the record, short-term sleep aids do now exist. They're new, and they're apparently similar in formulation to Zolpidem. I use one called "Sonata," and it's a 2-4 hour duration sleep aid. So if I only have five hours to sleep, I take it instead of Ambien. It's also prescribed for people who have trouble falling asleep but not staying asleep (I have both problems, but much more trouble with the "falling" side).
Oh, I should note, I think I make mention in the above comment about Sonata and Ambien being similarly classed drugs. I mean by that "nonbenzodiazepene (modern) sleep aids," and don't mean to imply that Zolpidem and Zaleplon are otherwise similar. They're imidazopyridines and pyrazolopyrimidines, respectively. (Yes, I had to look up the specific names of those two classes; I only ever remember that they're different and that Zaleplon's class is apparently related to insecticide).
What's really odd is that with all the new focus on sleep management thanks to these new drugs, I'm bumping into a few friends that actually get prescribed ... crud, I'm blanking on the name, but it's a tricyclic antidepressant that I think was traditionally used to medicate schizophrenia. I think it starts with "A". It's weird to hear of people taking it just for sleep.
That would probably be amitryptaline (brand name Elavil). It is a TCA (tri-cyclic antidepressant). At big doses, it can be used to treat depression (not schizophrenia). But, at whopping doses, it can be lethal (one of the reasons SSRIs are more in favor now). At small doses, it is really good for treating pain (including IBS-related pain and nerve pains). One of its side effects is sleepiness. Some docs prescribe it for this side effect because amitryptaline is really cheap. IMO, it would be better to prescribe the newer drugs for insomnia because TCAs act in a very non-specific manner (hence lots of side effects: dry mouth, sleepiness, constipation, etc.)
The one I was thinking of was Ativan, actually, which of course is not a tricyc at all, but still strikes me as overkill for a sleep medication these days.
Ambien is a great sleep aid. I used to take the 10mg dose and did great. I was able to fall asleep fast and stay asleep through the night. There are some side effects to this medication though. For example: The first time I took Ambien I had no side effects. I slept soundly through the night, no problems at all. After a few nights of taking it though I started to wake up in the morning and see that my furniture had been moved around or that my fridge door was open. I could not figure out what had happened until I asked my doctor. Supposedly when taking any hypnotic, it can cause you to sleep walk, or do things in your sleep that when you wake up you have no memory of ever doing. Overall though, it does what it's supposed to do.
This medcation has helped me tremendously! After the murder of my youngest son last year I was having horrible nightmares and couldn't sleep from midnight to daylight. Now I sleep peacefully and feel more rested.
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