Is Ambien (or Zolpidem) Safe, Does it Actually Work, and What Are Safe Alternatives?

Perhaps you've heard the sleepwalking stories, the loss-of-control tragedies, and the more humorous anecdotes of nocturnal disordered eating wherein entire birthday cakes, jars of peanut butter, and anything else in a cupboard is devoured. Despite the warnings, those plagued by insomnia—desperate for a goodnight's sleep— are still curious about Ambien. In fact, it remains one of the most popular prescriptions in America, boasting earnings that soared to 2 billion dollars at its peak.

Ambien is a sedative and is categorized in a class of medications known as hypnotics. This heavy sleep aid was created to combat insomnia. Ambien's effects are induced by the pill's ability to activate the neurotransmitter GABA and binding it to the GABA receptors. Essentially, Ambien slows down the brain through a process that works similarly to how benzodiazepines such as Xanax, Valium, or Klonopin ease anxiety. However, Ambien has some unique side effects.

Ambien's Newsworthy Side Effects

Though Ambien has an innumerable list of common side effects, there are a few that tend to make the headlines. Anecdotal evidence of adverse reactions to the drug, including sleepwalking, sleep eating, sleep driving, sleep sex, and even sleep shopping, have all be documented in recent years.

"When I prescribe Ambien and similar Z-drugs (a group of nonbenzodiazepine drugs with similar effects to benzodiazepines), I always ask about "complex nocturnal behaviors" like sleep walking," says AcousticSheep founder and MD, Wei-Shin Lai. "If they had it in the past, even as a child, I would be really hesitant about prescribing it."

While some headlines about the sleeping pill's side effects may seem humorous, this unconscious behavior can be both serious and fatal.

When Rhode Island resident Patrick Kennedy smashed his Ford Mustang into a barrier near the capitol building, it became the crash heard 'round the United States. According to ABC News, these sleepy joy rides have become a growing trend, with drivers smashing into parked cars, driving the wrong way down highways, weaving between lanes, or causing head on collisions that have killed, injured, or permanently maimed pedestrians. In fact, Ambien has firmly secured its position on various Top 10 lists that highlight drugs that most often cause motorist impairment.

Shortly after Kennedy's accident, Ambien manufacturer, Sanofi, was sued in a case that revolved around the drug's ability to cause unusual nocturnal binge eating behaviors. Susan Chana Lask commonly referred to the medication's effects on users as turning them into "Ambien Zombies." The class action suit resulted in Sanofi having to issue stronger warnings to the sleeping aid's users. Shockingly, the foods that were consumed by some Ambien users ranged from common snacks like peanut butter, chips, and cereal, to less common, sometimes bizarre combinations like buttered cigarettes and eggs.

Reducing the Dose

Because of the potency of Ambien, the FDA required Sanofi to reduce the recommended dose after it was found that women— who, according to a 2007 Sleep Study, are 1.4 times more likely than men to have insomnia— take significantly longer to flush Zolpidem from their systems. Consequently, to make the after effects of Ambien safer for its users, Sanofi had to cut the prescribed doses fully in half.

According to a report by Substance Abuse and Mental Health Services Association:

The total estimated number of zolpidem-related emergency department (ED) visits involving over-medication increased for both males and females between 2005-2006 and 2009-2010.
In 2010, females accounted for two thirds (68%) of zolpidem-related ED visits involving over-medication.
Patients aged 45 to 54 represented the largest proportion of zolpidem-related ED visits involving over-medication.
More than half of zolpidem-related ED visits involving over-medication in 2010 included other pharmaceuticals combined with zolpidem (57%).
Nearly half (47% of zolpidem-related ED visits involving over-medication resulted in either a hospital admission or transfer in 2010, 26% of which were admissions to a critical or intensive care unit.

Ambien Can Be Safe

Despite all these warnings, Ambien's more severe side effects are relatively rare and affect only 0.1% of it users. That being said, according to research by the New York Times, "60 million prescriptions were dispensed in 2011... About 40 million were for products containing zolpidem.

If one does the math, that puts nearly 40,000 people at risk for experiencing the more severe adverse side effects of Ambien. So, the question becomes: is it worth the risk?

Do Risks of Insomnia Outweigh the Risks of Ambien?

Insomnia and a lack of sleep in general can have a significant effect on a person's health. According to MD Health, side effects of sleeplessness can include but are not limited to higher risks of:

Cardiovascular disease
Cognitive processing difficulties
Depression
Diabetes
Heart disease
Injury by accidents
Judgement impairments
Memory Loss
Reduced sex drive
Skin damage
Stroke
Weight Gain

Alternatives to Ambien

If you're one of the 50-70 million adults in the U.S. that suffers from a sleep disorder, don't worry, you have more options than prescription sleep aids. Certain foods, herbs, supplements, and even technologies can help you finally get some quality shut eye.

Melatonin: Taking melatonin can help restore and improve sleep in people with insomnia and those suffering from symptoms of jet lag and shift work. Melatonin is not regulated by the FDA, so be sure to consult a doctor before taking this supplement.
Lavender: Essential oils are hotter than they've ever been. Whether you believe in them or not, lavender has been known to have a calming effect on those with insomnia. Taking a bath with this essential oil before bed can lead to a higher-quality night's sleep
Valerian Root: This herb has been known to treat insomnia and anxiety throughout the ages. According to WebMD, studies have shown 400-900 milligrams of valerian up to two hours before bed can significantly improve sleeplessness. Ask a doctor before treating insomnia with valerian root.
Lifestyle Changes: There are a few pre-bed rituals that many of us indulge in, but they don’t do us any favors when it comes time to sleep. To ensure proper sleep hygiene, try to do the following every night:
- Turn off your television before bed (you want it as dark as possible).
- Exercise earlier in the day or before work.
- Keep your room clean, tranquil, and comfortable.
SleepPhones: Relaxing music, meditative hums, and peaceful soundscapes can do wonders for a quality night's sleep. However, many headphones are bulky and difficult to sleep with. For that reason, invest in physician invented SleepPhones from AcousticSheep to increase the quality of your shuteye.