April 24, 2007

Ambien Goes Generic as Crowds Cheer

So the FDA just approved generic Ambien and a lot of folks are going to be saying hooray! Crabby has noticed that the drug is extremely popular among many of her friends and loved ones--particularly the go-getter types who work long hours and get sent all over the world for their jobs and have to sleep on bouncing planes or in noisy hotels in weird time zones.

It's actually kind of cute: they hoard their pills and count them and fuss over them. They worship those little magic beans that can turn a miserable red-eye flight into a peaceful trip to dreamland. Crabby knows a lot of people who use the drug this way: occasionally and sensibly. She makes no judgements about that.

Actually, she has no judgements, either, about those who use drugs every night for long periods of time. Chronic insomnia sucks. Getting more and more exhausted, depressed, sick all the time, cranky; trying everything you can think of but nothing works? Sounds awful. (Crabby, being lazy, gravitates naturally to low-energy states. Sleep is not a problem unless it's her own damn fault, and when it is, she knows how to fix it if she's not being stubborn. More on this, perhaps, at a future time).

There are any number of articles like this one that must drive people who have insomnia crazy. They always make it sound like making a few simple changes in your routine is really all it takes. Sure, all that stuff helps. But for those who just seem to have the wrong biology for easy sleep, it doesn't fix it. They still mostly can't sleep.

So resorting to nightly medication is understandable. But as you may have heard, if you use drugs like Ambien for extended periods of time they may produce some, well, inconvenient side effects. Like "complex sleep-related behaviors which may include sleep-driving, making phone calls, and preparing and eating food (while asleeep)."

Gadzooks! None of these are behaviors Crabby would want to engage in while asleep.

While not as bad as killing yourself or others while behind the wheel, or alienating all your loved ones by phoning them in a psychotic dream state, eating while asleep strikes Crabby as pretty darn unfair in its own right. All those real calories actually count when you could be consuming dream calories free of charge?

(There are also tales of people making cigarette sandwiches and other nasty midnight snacks while asleep, but Crabby couldn't substantiate these with any links. But she swears she heard it was true.)

So no easy answers here on the insomnia question. Do any of you have trouble sleeping? What do you do about it? Crabby will share her methods in a future post, because they work for her, but any true insomniac would just laugh.


Bunnygirl has posted an awesome, articulate comment below challenging the very way we frame discussions of insomnia. Do any insomniacs (or friends of same) take issue with this? Please weigh in.


  1. It's one thing if a person has a diagnosable sleep disorder, like apnea, or if they jet around the world all the time and can never quite synch up with the local time.

    But most people, IMO, simply worry too much. I've watched my husband work himself into a tizzy because he didn't get the "right" number of hours of sleep at the "right" time. And then he can't sleep because he's so anxious about it!

    No one has died from lack of sleep. Everone's sleep needs are different, and one's sleep needs change at different ages and even from one day to the next.

    I say if you can't sleep, embrace it. Read a slightly dull but informative book. Knit. Do something useful or educational, but repetitive. You'll either get sleepy or end up learning/accomplishing something. Win/win. And if you're tired the next day, well, you'll sleep that much better the next time you hit the hay.

    Get tired enough, and you will sleep. Really. I finally convinced my husband of this and he never has any trouble sleeping now. Go figure.

    For myself, I sleep twice a day-- in the early evening after I get home from work, and between about 1:00 am and 6:00 am. I've always been a night owl, and this is the schedule that works for me. My sleep pattern is considered dysfunctional in America, but would be thought quite normal in Barcelona. This just goes to show how much of our sleep mythology is determined by culture. There is no right or wrong way to sleep!

    I maintain that if there's no underlying medical pathology causing sleep difficulties, most insomnia is all in the head and is due to people trying to force themselves into a sleep pattern that their body just isn't designed for, like trying to squeeze a size 12 body into a size 2 dress. Of course it doesn't work!

    Some people truly cannot arrange their work and home life in such a way to take advantage of their body's natural sleep rhythms. These people have my sympathy, and there's no easy solution. But for a lot of us, it really boils down to working with our body instead of against it.

  2. Hi, Cranky - First, let me say that I love your blog! I'm an ER nurse that works weekend nights and although a good workout is the best "pill" there is, find that I occasionally have to take Benadryl to help me get to sleep. At work, I'm seeing more and more patients list Ambien as a routine medication, which I find rather disheartening. Benzodiazapines are easy to abuse, and becoming dependent on them makes for even more dysfunctional sleeping patterns. There are much safer alternatives out there (like a really boring audiobook!).

  3. Hi Debbi!

    Yah! An actual medical professional who knows things!

    Crabby hopes you will come back often and let us know how the things we're discussing in the abstract actually play out in the real world of hospitals and patients.

    Or you can weigh in on how you feel about M&M's--that works too. So glad you found us!

  4. I've never taken a sleeping pill. My bouts with insomnia have been occasional, usually situational, and mild.

    bunnygirl's post makes a lot of sense. Which, given her nick, surprises me a bit. ;)

  5. Bunnygirl, your comment rocks. I used to be like your husband, an insomniac who worries too much. Sometimes I still worry a bit too much about sleep, but over time, I've been coming more and more to the realization you've come to -- that things will sort themselves out, I'll sleep when I'm sleepy and wake when I'm "wakey", and when I can't sleep, I take advantage of the extra time I have. Actually, I wish people didn't have to sleep at all. We sleep up to a third of our lives away, and it kind of seems a shame to me, ya know?

    And Crabby, I've been there with the chronic insomnia -- some years ago, there was a period of about two weeks during which I think I slept about two hours. Seriously! It was that bad. But the bottom line problem was what bunnygirl describes in her comment about (1) trying to force my natural rhythm into a schedule that didn't work for me and (2) getting so anxious about sleep that I sabotaged any chance I had to actually sleep.

    Anyhow, great discussion topic!

  6. As an insomniac, I never worried about the hours of sleep I was losing. I just fumed. Lay there in bed and fumed as one hour, two hours, three hours ticked past. Then I followed the received wisdom of getting up and doing something. Might as well use the time instead of letting it fail to Fulfill Its Potential. This is sensible, but the radio still comes on at 7 a.m. and I still have to drag my carcass out of bed and get to the office. I don't have the luxury of taking a European-style post-prandial siesta during the workday. The building I work in, constructed in the 1960s, used to have a Quiet Room where stressed-out drones could retreat and let their minds go blank or even nap, if they didn't mind how cold the room was. Then the room was done away with in remodeling. I have colleagues who tuck themselves under their desk for a snooze when the infamous 3 p.m. slump arrives. I've mastered the art of napping in my chair, at my desk, sitting upright. But I work in a cubicle. Wouldn't do to disturb my cubie neighbor with snoring. So I find an unused conference room, close the door, and often manage to drift off refreshingly for a few minutes. However, this tactic helps me catch up on a precious morsel of the sleep I've lost. It doesn't prevent me from waking in the middle of the night -- often 12 hours after that mid-afternoon slump -- with my mind racing. I don't take Ambien, though. A single chaste white Trazodone usually helps.

  7. Hi Appleton,
    Yikes. You have nicely confirmed for me what I suspected--chronic insomnia sucks.

    I've read somewhere you're supposed to avoid naps, but of course these suggestions always leave out how the instructions on how you're supposed to get through your day in a state of utter exhaustion.

    I can't nap easily in public myself, even when its completely appropriate, like on a plane. Some archaic part of my brain thinks I may be attacked and eaten at any moment so I jerk awake whenever I start to doze.

  8. Naps can be disruptive, true, but I've read something different, that they're okay in moderation -- never nap during the day for more than 30 minutes. That's more than I ever manage to snatch.


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