Sleep disorders like insomnia are among the most common health issues that Americans face each year. Busy lifestyles and constant stimulation may contribute to widespread sleep problems. According to the U.S. Centers for Disease Control and Prevention, a third of American adults don’t get the recommended sleep they need each night. Sleeplessness may seem commonplace to many adults—a mild problem that can largely be ignored. However, sleep problems can lead to serious consequences like depression, type 2 diabetes, obesity, and heart disease.
Since this is such a common but significant problem, many people seek a reliable remedy for sleep disorders, including doctors and researchers. Central nervous system depressants have been available as medicine for more than a century, but prescriptions like Ambien are relatively new. Are they a viable treatment, and what happens when you use the drug for a long time?
What Is Ambien?
Ambien is a popular brand name for a drug called zolpidem, which is used to treat sleep disorders like insomnia. It’s similar to benzodiazepines, but it’s in a category of drugs called non-benzodiazepine sedative-hypnotics. They’re also called Z-drugs in reference to their tendency to have the letter Z in their name.
Z-drugs are central nervous system depressants like benzodiazepines, barbiturates, and alcohol. Unlike those other depressants, they’re relatively new. Benzodiazepines were the most commonly used depressant prescription since they gained popularity in the 1960s. Ambien was first approved by the Food and Drug Administration in 1992, and generic forms of zolpidem were introduced in 2007.
Barbiturates were introduced in the late 19th century, but they came to be known to cause serious side effects like dangerous overdose and addiction. They were largely replaced as a common household depressant by benzodiazepines in the 1960s and 1970s. Though benzodiazepines are less likely to cause accidental, fatal overdoses, they can still lead to chemical dependence and addiction. Z-drugs like Ambien have comparatively mild effects, so they’re thought to be safer for common problems like insomnia and sleep problems. However, they too can come with some significant side effects.
The rates of abuse and overdose involving Ambien are low compared to other depressants. But the drug can be misused, which can cause some consequences. Like other depressants, some people may seek to use Ambien recreationally to achieve a euphoric, relaxing high. When Ambien is used as directed, it’s intended for short-term therapeutic use.
If you’re having sleep troubles, Ambien may be able to correct any chemical imbalances that are causing it. But some people experience chronic and recurring sleep problems, and they may take Ambien for longer than it is intended to be used. Both recreational use and using the drug for too long may lead to problems like dependence and addiction. However, long-term use may also lead to other mental and physical problems.
Can Ambien Cause Short-Term Side Effects?
There are some short-term side effects that are associated with Ambien, even if you use the drug as directed. As with any prescription medication, it’s important to work with your doctor to find the right dosage and medication for your needs. There is no magic pill that will solve your sleep problems immediately. Instead, you may find that your doctor will have to adjust your dose or switch medications to minimize side effects.
Common short-term side effects can include dizziness, weakness, sluggishness, tiredness, and daytime drowsiness. In some cases, you may experience drowsiness the morning after you take Ambien, especially if you take a long-acting extended-release tablet. Next-morning drowsiness can be dangerous if you attempt to drive the next morning.
In some cases, Ambien can cause something called complex sleep behaviors, which is identified by sleepwalking and doing other activities while asleep. In some cases, these activities can be dangerous, like when someone drives their car while asleep.
Ambien side effects may be more likely and more severe if you misuse the drug. Taking high doses can cause you to experience more severe adverse effects like heavy sedation, loss of coordination, headache, nausea, balance issues, muscle weakness, and confusion. These symptoms may be more pronounced if you mix Ambien with other depressants or opioids. Mixing Ambien with alcohol can also increase the intensity of your symptoms and side effects.
Mixing depressant drugs can be dangerous and even life-threatening. One of the most dangerous adverse effects is respiratory depression, which is when your breathing slows or stops.
How Does Long-Term Ambien Use Affect Your Body?
Ambien is meant to be used for short-term therapeutic relief. Long-term use without breaks can cause some dangerous side effects. The most common consequence of long-term use or misuse is tolerance. Tolerance is when the drug becomes less effective as your body gets used to it.
In order to get the same benefits from Ambien as you did when you first started taking it, you’ll have to increase your dose over time. You may also become chemically dependent on Ambien. If you stop using the drug, you may revert back to insomnia along with other uncomfortable withdrawal symptoms. Tolerance and dependence are caused by biochemical changes in your brain as it attempts to adapt to the drug in your system. If you use Ambien in high doses for a long period of time, you may encounter severe withdrawal symptoms like seizures.
Long-term Ambient misuse can also increase your risk of an overdose. While overdose on Z-drugs is thought to be less severe than overdoses on other prescription depressants, high doses can be potentially dangerous. An overdose can lead to loss of motor control, dizziness, sedation, vomiting, loss of consciousness, and slowed breathing. If you or someone you know takes a high dose of Ambien and either stops breathing or can’t be woken up, call 911 immediately.
Many depressant drugs can be more dangerous among the elderly. Older people lose their ability to effectively process Ambien and other depressants over time. If you’re older than age 65, your doctor might try to find other sleep aid alternatives to help you. In older people, Ambien may increase your risk of dementia. A study in Taiwan found that a cumulative dose of zolpidem was linked to an increased risk of dementia, especially among people with other health issues like high blood pressure, diabetes, and strokes.
Dementia is characterized by a period of cognitive decline that’s most often seen in older people, but it may also be caused or exacerbated by other factors. The study found that 2% of people that were treated with zolpidem experienced psychomotor impairments or impairments related to cognitive functions and physical movement. None of the placebo groups experienced the same impairments. The study also found that dementia was reversible.
There are also some less common side effects of Ambien use that may be more likely if the drug is used for too long. These side effects can include joint pain, heartburn, hearing loss, and hallucinations.
Can Ambien Cause Psychological Side Effects?
Ambien can potentially cause some mental and psychological side effects as well. Ambien and other central nervous system depressants often come with the warning that they can cause or worsen depression. The drug manipulates a chemical called GABA, which is closely tied to rest and relaxation. But too much depression and relaxing effects can cause you to experience low mood, depression, and listlessness. If you experience new or worsening depression while taking Ambien, speak to your doctor as soon as possible.
What Can You Do About Insomnia Without Ambien?
You may have taken Ambien and continue to have sleep problems. Or you might be in recovery from addiction to depressant medications, and you’d like to avoid Z-drugs like Ambien. If you’d like to avoid using Ambien, there are several ways to improve your sleep without prescription-strength medications.
Good habits that can help you to achieve healthy sleep are often called sleep hygiene. According to the CDC, sleep hygiene may include things like:
- Keeping a consistent sleep schedule
- Keeping your bedroom dark and comfortable; and
- Avoiding large meals right before bed
Set aside your bed for sleep and nothing else. Lying in bed to watch movies or scroll through your phone can create habits in your brain that prevent sleep. If you associate your bed with only sleeping, it may be easier to shut down rapid thinking and energy levels when you get into bed.
You may also need to address underlying issues that are associated with insomnia, like anxiety. Anxiety can cause racing thoughts, worry, and even physical reactions like an increased heart rate that can keep you up at night. Anxiety can be treated with psychotherapy and cognitive-behavioral therapy. These treatment options can address problems in your life that are at the root of your anxiety issue. You can also learn coping techniques to help deal with the anxiety that keeps you awake when it’s time to sleep.