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Posted 10/29/2007 8:32 PM (GMT 0)
A number of you have mentioned in the past that you have problems with insomnia, and use various sleeping aids. I too am a long-term insomniac. Part of that stems from physical discomfort (and mental anxiety) over my Crohn's disease, some marital problems (again with attendant anxiety), and now (possibly, but not certainly) my recent experimental use of naltrexone. Anyway, whatever the cause, I have more trouble sleeping now than ever before.

I do have a prescription for Ambien, or rather, it's generic equivalent zolpidem. For me, it works fabulously. My biggest concern is its potential addictiveness. I haven't been taking it very long, and I deliberately keep the dose small, usually breaking the pills in half. I even try to take it only on alternate days, but that means that I suffer some bad nights where I don't get much rest. Ideally, I wish that I didn't need a sleeping aid, but since I apparently do, I'm wondering what I can use to fill in those days that I skip my zolpidem dose.

I've been doing some online research (thank you, Wikipedia). It seems that Ambien is one of the least addictive sleeping medications on the market, but nevertheless it's still habit forming if you take it long enough. Most of the other well-known sleeping aids are much more addictive, especially drugs classified as "benzodiazepines," including flunitrazepam (Rohypnol), clonazepam, lorazepam (Ativan), alprazolam, and particularily temazepam, nitrazepam, and nimetazepam. Barbituates and chloryl hydrate are also considered addictive, make good suicide drugs and thus are seldom prescribed these days.

One drug that gets heavily advertised in the USA these days is trade-named Lunesta (eszopiclone in the USA, zopiclone elsewhere). The commercials make it sound like it's non-addictive, but the Wikipedia indicates otherwise. Also, some potentially nasty side-effects are noted:

Common side effects:

* unpleasant bitter or metallic taste
* headaches
* cold-like symptoms
* pain
* daytime drowsiness
* lightheadedness
* dizziness
* loss of coordination
* upset stomach
* vomiting
* decreased sexual desire
* painful menstruation (periods)
* breast enlargement in males
* heartburn
* unusual dreams

Less common side effects can include:

* rashes
* itching
* chest pain
* swelling of the hands, feet, ankles, or lower legs
* painful or frequent urination
* bloody or cloudy urine
* back pain

I'm wondering - anybody here taking it? Are you suffering any of these side-effects? Any problem with it becoming habit forming?

One more non-benzodiazepine drug that interests me is trade-named Sonata or Starnoc (zaleplon). Like Lunesta, is supposedly less addictive, but has some side-effects. Anyone have any experience with this?

Lastly there is Unisom (doxylamine succinate), which is sold across-the-counter in the USA. It's an antihistamine, often used in cold medicines. It's considered non-addictive, but not as effective as prescription drugs. Since it's easy to buy, I will be trying that too. Just wondered if anyone has comments about it? I have heard it can contribute to glaucoma, which has actually been a problem for me in the past.

All comments welcome.

best regards,
Robert
Posted 10/29/2007 9:43 PM (GMT 0)
Hi Robert:

I have suffered with episodes of insomnia for 15 years and had never taken anything other than an occasional gravol. Two years ago, however, I was dealing with the return of crohn's after surgery and some other health issues -- I hit an emotional wall. My physician prescribed zopiclone. I used it once full strength and had a bizarre incident. During the night I apparently soild the bed, got up, changed the sheets deposited the soiled sheets in the bathtub, cleaned myself up, changed my nightclothes and went back to bed. When I awoke in the morning I was stunned to find myself dressed in something other than that in which I had gone to bed. Thank heavens I had my husband there to explain what had happened because I did not remember -- and still don't -- anything about the episode. My husband said I behaved like someone fully alert and awake, but all I can remember is a series of dream images. So I would say the most distressing symptoms associated with this medication is night arousals and amnesia.

That being said, I eventually tried the medication again, only this time, like you, I halved the dose. It worked and other than a bitter taste and occasionally listlessness the next day, I have continued to use this medication when it is absolutely necessary.

I don't take it more than two nights in a row and have done a lot of mind/body work over the last two years to reduce my stress levels. As a consequence I no longer feel like I need it, but I'm glad it is still an option for those times when I am having problems.
Posted 10/29/2007 10:12 PM (GMT 0)
robert - hmmm, where to start? i have had insomnia for about 4 or 5 years now. it has gotten increasingly worse when i started to experience the god awful pain from my crohn's and since my diagnosis. i have taken ambien and also it's generic. for some reason on the generic, after being on it for about a month i started to get hangover effects during the day. though i was sleeping a full night of sleep i felt like an absolute zombie and was getting terrible headaches. after that i am i went on trazodone, which was working pretty good for the past 2 months but since i have been on steroids i am having trouble staying asleep. typical night, go to bed at 10:30pm only to be wide awake at 3am. usually at that point i just get up and nap later in the day as i have taken a leave from work. i recently changed over to restoril. not having much luck with this one either. first night i slept 4 hours, 2nd night - 3 hours and last night an awful 7 hours off and on. my pcp wants to put me on a daily anti-anxiety as he thinks that may be the underlying problem. he doesn't want to keep me on the restoril as it is a benzodiazepine and can be addictive. before i was on prescription sleep meds i tried everything under the sun from otc sleep aids to valerian root, melatonin, sleep md ...you name it. nothing worked. if you do end up taking lunesta please let us know how that works out for you.

take care!
Posted 10/29/2007 10:25 PM (GMT 0)
I take diphenhydramine HCl, which is the sleep ingrediant in Tylenol PM and so is available over the counter. They say it is non habit forming. Simply Sleep is their version without the Tylenol. There are also lots of other brands out there that use this including a generic Walgreens verson. Works fine for me. Prednisone was keeping me awake.
Posted 10/29/2007 11:33 PM (GMT 0)
Tolerance develops quickly (for most people) on drugs like diphenhydramine and doxylamine. So if you use them frequently they will stop working.

I didn't have a successful experience with ambien. It would give me about 5 hours of coma like sleep and then I would be wide awake. A nurse explained to me that different people have different reactions to sleep medications. There is the group like ozonehole and ambien works great for them. there is another group in which people find that they have to take a break every few days or it stops working well. Then there is another group like me that it works for but not well enough.
Posted 10/30/2007 12:55 AM (GMT 0)
I've been on Ambien and the generic off and on for about a year. It has been a life saver for me since I suffer from bad insomnia but have terrible fatigue during the day. I do find if I take it too many days in a row that it loses it's effectiveness so I usually skip it during the weekend and take naps. I have to get up early in the morning during the week so I need to get a good night sleep. I guess I'm one of the lucky ones that it has been a blessing.
Posted 10/30/2007 1:12 AM (GMT 0)
Ambien sorta kinda works for me. I fall asleep for awhile and then wake up in this "twilight" sleep mode, where I'm half-awake/half-asleep and sort of feel paralyzed. Last time (in hospital) I was convinced my sister was there and we had this whole conversation. Of course, in the morning, I realized it was a hallucination of sorts. Ativan works way better for me, but can only use it sparingly due to worries about dependence.

Luckily not needing anything right now, but will ask for something other than Ambien next. Curious to hear about Lunesta, et al.
Posted 10/30/2007 4:34 AM (GMT 0)
First, thanks to everyone for their replies.

From what I've been reading on Wikipedia, zopiclone (that Belleenstein mentioned above) is a slightly stronger version of Lunesta. I understand that Lunesta is fairly expensive in the USA (around $5 per pill). I've heard it's much cheaper in Mexico, and will go check that out (I live only 10 miles from the Mexican border).

about Ambien (zolpidem)...One thing I've read a number of times is that you should never take it with alcohol. Not even a sip. There have been a number of cases of people who have mixed Ambien with alcohol, only to awaken the next day in jail and not knowing how they got there. Apparently, the combination puts them into a hypnotic-like trance and they may do things, like go drive a car (and crash it), walk around the neighborhood naked, etc, and they won't remember a thing. There are even lawsuits that have been filed against the drug companies by people who have had these bad experiences. So if you were thinking about maybe enhancing the sleep effect by having Ambien with a glass of wine, I suggest you don't.

For myself, I've had very positive results with Ambien. But then I take a half-dose, and I never drink alcohol. Indeed, I don't even keep liquor in the house.

Dustspeck mentioned above using melatonin. I have tried that, and yes, it helped a little, but it is specifically NOT recommended for people with autoimmune diseases. There is even a warning printed on the bottle. I used it for awhile and my Crohn's did indeed begin flaring, though that could have been a coincidence. Anyway, it wasn't a very powerful sleep aid, and certainly not worth it if it will increase my illness.

If I get a chance to try Lunesta, or perhaps its close relative zopiclone, I'll report back my experience.

best regards,
Robert
Posted 10/30/2007 6:50 AM (GMT 0)
I don't take prescription tablets for sleeping but occasionally if I'm feeling stressed out I'll take an extra strength Valerian before bed and it works well for me.
Tess
Posted 10/30/2007 6:54 AM (GMT 0)
I was put on ambien cr. The first night I took it I layed down.. and remember waking up the next morning feeling fine. The bad part about the whole incident was apparently after I fell asleep I got up, called my cousin on the phone, talked to her for about fifteen minutes.. then walked into the living room and started talking to my now ex husband. It took him about half an hour to realize I was asleep haha. He sent me back to bed and had to babysit me the rest of the night. I haven't touched the stuff since. Just be careful when getting into some of this stuff :). I haven't tried anything since. I use the exhaustion method O.O.
Posted 10/30/2007 9:27 AM (GMT 0)
I've taken both zolpidem and zopiclone, and had bad experiences with the latter. Ambien is fine, great, but zopiclone did something weird to my brain, I think. about a half an hour after I took a pill, 10mg, I was like babbling incoherently and unable to form sentences or think. It made me stupid. And it made my mouth taste absolutely awful - I kept drinking water, but it wouldn't go away. I'm sure most experiences aren't like mine, but I know I'm not taking zopiclone again.
Posted 10/30/2007 1:19 PM (GMT 0)
I have had the sleepless nights for about a year.  Because I would have anxiety attacks, I was prescribed Xanax.  My attacks got better, but my sleep pattern did not.  My doctor suggested taking one before bedtime and they worked great.  But then one wasn't enough, then two wasn't enough.  I realized that I needed to stop them and that's exactly what I did.  I was then given Ambien and Ambien CR samples.  They worked, but there was the "I don't remember what happened" moments and then my insurance only wanted to pay for 8 pills a month!!  I gave up on those as well.  Then I remembered what my GI suggested to me after my surgery, but I never tried it b/c I thought he was just looking down on me and thinking I was making this NO SLEEP thing up. 

All I have to say is MELATONIN PILLS!!!  They are available at any of your local drug stores or Wal-Mart.  It is a purple bottle.  The large one runs about $8.  I believe I have the 3mg pills.  I take two before bedtime and I sleep like a baby EVERY time.  There is no grogginess, no headaches, no "I don't remember" moments, and they are also a natural supplement.  I highly recommend these.  It is def. worth a try before you have to get a prescription or fight with your insurance to cover that prescription.

Melatonin pills.......try them!

Posted 10/30/2007 3:19 PM (GMT 0)
Hi Robert,

I have suffered from insomnia for years. I started out taking Tylenol Simply Sleep, then found out it was just Benadryl...much cheaper to just buy the Walmart brand! It worked for awhile, then I had to start taking more and more....typical for us with Crohn's, hmm? Everything stops working so well after awhile.

After my hysterectomy, I couldn't sleep at all. My gyn prescribed Ambien to me. It worked wonders! I had a prescription for 15, then he gave me another 15 days. I didn't have any trouble with addiction to it, nor with withdrawl. I'm actually going to get another prescription from my GI tomorrow (she was out of prescription pads the last time I saw her, but ok'd the Ambien). I slept like a log on Ambien, until the time I couldn't stand a full bladder any longer, maybe 4 or 5am. The only problem I came across was that when my brain shut off, the rest of me did not. I guess I'm on of those people who could go out and drive on it (my husband hid the car keys every night!). I would take the Ambien, slowly drift off in my mind, then not remember anything that happened. I could stay up for hours, talking about crazy things, argueing about actually going in to bed, having crazy IM conversations that were very hard to read (friends have C&P'd them for me to laugh at), I've made food, sat by a campfire for hours, and for some reason, talk about things that are not exactly meant for all my friends to hear! The sleep was so restful and wonderful though, and I'd wake up the next day feeling refreshed and rejuvinated.

I do know two people who have become addicted to Ambien, though. One was able to stop taking it on her own. The other, unfortunately, drove while on it, crashed her car twice, and got into a lot of trouble with the pharmacy. She was taking almost a month's worth of Ambien in one day....how that's possible, I can't fathom. She is in jail/rehab right now because of this. So that's something to be aware of....it's a dangerous drug, but also a very helpful one for those of us who cannot sleep.

I've often wondered about Lunesta, since they say it is less addictive than Ambien. Those are an awful lot of side effects though.

Best of luck to you, I wish you many good nights' sleep!
Posted 10/30/2007 7:00 PM (GMT 0)

jamief said...
I was put on ambien cr. The first night I took it I layed down.. and remember waking up the next morning feeling fine. The bad part about the whole incident was apparently after I fell asleep I got up, called my cousin on the phone, talked to her for about fifteen minutes.. then walked into the living room and started talking to my now ex husband...Just be careful when getting into some of this stuff :). I haven't tried anything since. I use the exhaustion method O.O.

Hi Jamief,

Yes, there is a lot to be said for the "exhaustion method," though it doesn't always work for me.

about Ambien CR - my doctor offered to prescribe it, but after some investigation I decided that plain old Ambien (or rather generic zolpidem) was better. Why? Because the "CR" variety is a timed-release version. That might sound better (and in some ways it is), but it means you cannot cut the pills in half - you must take the full dose. If you do cut them, that will cause too much of the drug to be released at one time.

Ambien or zolpidem is available in 5 or 10 mg pills. I either cut a 5 mg pill in half, or a 10 mg pill into quarters. So I never exceed 2.5 mg in a dose. That's really all I need, and if I find that it's not effective, I'll have to stop taking it for awhile.

By the way, the first time I took Ambien I did take a full 10 mg because I didn't know better. I'm not really sure what happened, because no one was around to tell me. I can say that I have no recollection whatsoever of the 10 hours that I was under the influence, and that's scary. I might have been sleeping the whole time, or maybe walking/driving around outside, I don't know. And that's scary. So my two conclusions are that: 1) keep the dose small, and 2) yes you are correct that these drugs should be handled with care.

best regards,
Robert
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