On Ambien

If you happen to follow me on Twitter, you know that earlier this week I had a rather trying day that involved spending several hours in the ER.

What happened wasn’t life threatening, and I’m fine now. But it was preventable, which is why I want to share my experience here.

The cause of my incident was Ambien, the sleep aid.

Please read through this if you are considering taking Ambien or something similar. If you are taking it now and have arguments for it, I am happy to hear those. But as it stands, I don’t advocate its use.

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The Script

I had been having trouble sleeping soundly for months, and was prescribed Ambien as a short-term solution to get me back on track.

I was immediately warned that Ambien could cause sleepwalking. My doctor mentioned that this could involve the completion of fairly complicated tasks, like fetching something from the kitchen. He told me that when I took it I needed to be in bed, with the lights out, ready for sleep, or else I could end up having amnesia about anything I attempted to do between when I took the pill and when I actually went to sleep.

My doctor even outlined a horrifying scenario: It could technically be possible to take Ambien in the morning and go throughout your day fairly normally, and later not be able to remember a thing about it.

I was shocked that something with that type of an effect was on the market and so readily available. Add to this the fact that I am generally reluctant to take drugs of any kind — even ibuprofen — and you can imagine my reluctance to take it. But sleep is crucial, so I filled the script with a generic.

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The First Time

I took Ambien once while at my apartment in San Francisco, and had a fine experience with it. When I woke up, I didn’t feel refreshed as I had hoped, but I had slept through the night, which was something my body desperately needed.

By that time, I had talked to a few friends who had personal experiences with Ambien. One thought it was swell and never had any problems. Another said he once had a half-hour conversation with his girlfriend that he couldn’t remember, but that he still recommended it. In his view, the amnesia was a minor inconvenience compared to the great benefit of sound sleep.

Despite this feedback and my own positive initial experience, I remained dubious. I was haunted by the image of someone going throughout their day while on Ambien — talking on the phone, riding the MUNI, maybe even going to work — and then later remembering nothing about it, as if it had never happened.

I left the bottle by my bedside, but kept the lip screwed shut.

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The Relapse

A week or so later, I flew to Florida for the holidays. Coming home had always relaxed me in the past, but this year the time change compounded my sleeping problems and I found myself awake until 5 a.m. against my will.

I told my dad about it, and he emailed me a link to this scientific find: A woman wrote multiple emails to friends while on Ambien.

This news added to my fear, but I was growing desperate. I took it again, and finally got some sleep. The next day I was so happy about it that I joked about changing my name to Heather Ambien. I was in love with its effect.

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The Mistake

I skipped the next day, and to my dismay found myself back on a bad sleep cycle the following night. I wasn’t able to fall asleep until the wee hours of the morning, and only slept lightly for a couple of hours.

Awake at 5 a.m., groggy and desperate for rest, I resolved I would take an Ambien right then and there so I could feel like myself again.

My mom, a schoolteacher, was already awake and rummaging in the kitchen. I went to tell her I was about to take Ambien, and that she shouldn’t attempt to wake me up to say goodbye.

Shortly after, I went to bed and took the pill. Immediately, I was filled with regret. I wanted to start my day soon, I realized, not be asleep for another seven hours. But it was too late. At that point, I didn’t have any say in the matter.

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The Fall

After laying in bed for a couple of minutes and realizing my mistake, I got up to quickly use the bathroom. I knew I didn’t have long before the Ambien would start to take effect.

While in the bathroom, my ears started ringing loudly — my personal alarm system for when I’m about to faint, as I’ve learned through years of shots and blood draws.

I walked into the kitchen to tell my mom that I felt like I was going to pass out. Then, somehow, I was on the ground eight feet away, my face planted solidly in our tile floor, my mouth full of blood.

My mother was by my side, nearly as confused as I was about what had happened.

“How did I– ?”
“I don’t know. You fell when you ran into the glass door. Is your nose OK?”
“I ran into the door?”
“You were talking to me and you tripped on the ironing board. Then you stumbled into the chair. I didn’t know where you were going. It looked like you were walking to my room. But then you ran into the glass door and fell.”
“But I– “

Slowly, I got up, pressing my tongue against the wound in my lower lip. I had no recollection of any of that.

- – -

Out of Control

Neither my mom nor I knew quite what had happened or why. We suspected the Ambien, but it seemed like such a drastic thing to happen mere minutes after ingesting it. Surely, there was something else at play.

Whatever the answer, we didn’t have much time to talk about it, as soon the shock from my fall would subside and I’d be pushed into a drug-induced slumber.

I managed to notify work that I wouldn’t be in that day as my mom did the same. I crawled into her king size bed and held an icepack to my face as I waited for the sleep that I no longer wanted.

I wanted to know what was wrong with me and get stitches if I needed them, but that would have to wait. The Ambien was in control now, and there was nothing I could do but obey.

- – -

The Doctor, The Hospital

What followed was a long and boring eight hours spent mostly in waiting rooms. First, at the urgent care doctor for my lip (no stitches needed, but tetanus shot given), and then during a trip to the emergency room, as recommended by the PA with an exclamation point at the end. He, too, didn’t believe that the Ambien was the cause, so soon after taking it.

My lip hurt and I had other scrapes and bruises, but worse I was confused and frightened by what had happened. Why were those several minutes of my life missing from my memory? How had I managed to stumble into not one, but two large objects before being sent to the floor by a sliding glass door?

All day the incident was discussed as syncope — sudden, unexplained fainting. To get to the root of its cause, they took blood and urine samples, and performed a CT scan.

- – -

The Diagnosis

At almost 10:30 p.m., more than 17 hours after the incident, I was given a diagnosis: sleepwalking, caused by Ambien.

I hadn’t fainted. I had passed into a sleep state while erect and talking to my mother. When I came to on the floor, I was waking up.

- – -

The Worry

While I was relieved that it wasn’t a larger problem, I was still shocked by the news. Ambien had really done all that? Ambien is why I feel like I’ve been beat up in a scuffle? Ambien is the reason I’ll have a scar below my lip?

I imagined all the ways in which things could have been much worse. I could have been alone, and walked out the door into traffic. I could have fallen onto something sharp.

I thanked God that none of those things happened, but immediately began to worry about everyone who takes Ambien and could possibly suffer through something similar. Millions of people have difficulty sleeping, and Ambien has commercials on TV that make it seem dreamy in more ways than one. Who knows how many people are convinced, and take it.

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The Advice

I later discovered that my dose was partly to blame. I was prescribed 10 mg, which is not a lot for most drugs, but is the highest available for Ambien. I was never told to cut the pills in half to start off with, though that’s a common practice, according to a friend who’s a nurse. In fact, I was never told of any alternatives at all. If I had, this may not have happened.

I’m not a scientist or a doctor. I am, however, someone who had a terribly disorienting, frightening, and potentially very harmful experience that she wouldn’t wish upon anyone else. So I’m sharing a few words of my own, non-expert advice:

If you are taking 10 mg of Ambien now, it may be worth it to ask your doctor if you can take half instead. Or, like me, you could get off it all together and try these safe alternatives:

• Less sugar, no caffeine
• More cardio
• Sleepytime tea
• Earlier computer cutoff time
• A bath before bed
• Food with a low glycemic index prior to sleep

All of these things can help regulate and calm your system, and there’s lots more you can do, like schedule meals and stick to an extended pre-sleep ritual.

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It hasn’t been long enough to tell how effective all of these things will be in helping me sleep better, but already I have a greater peace of mind knowing that I am in control of my body and brain.

If you’re taking Ambien, please be careful. If you’re not, try safe alternatives before you jump into something as serious as a prescription sleep aid.