Have Insomnia? The Risks of Mixing Ambien and Parenthood

If people can have no memory of driving, eating or having sex under the influence of Ambien, how can parents who use this medication limit risk to their children?

Have you ever suffered from severe insomnia? If you have you know just how critical regular, decent sleep is to normal daily function, mood, physical health, family dynamics….everything! I suffered from horrible insomnia off and on for a few years. It started when my son was born – when my “mommy” senses kicked in and woke me up at the slightest noise. And then it got worse when I started traveling a lot for work and I developed a painful and chronic back problem. It got to the point where I could only function by using a rotating schedule of sleep aids…Tylenol PM, NyQuil, and prescription sleeping pills.

AmbienCR picOne of the most effective – at least in the short-term – was Ambien (also known as Zolpidem). Ambien is part of a constellation of drugs called sedative-hypnotics. This grouping also includes other well-known medications such as Klonopin, Xanax and Valium (all of the benzodiazepine class). Ambien and Lunesta are not “benzos” but are related types of sedative-hypnotics. For someone suffering from insomnia, or traveling internationally across many time zones, Ambien can seem like a gift from the gods. You fall deeply asleep almost instantly….at least at first….and even if you wake up before your alarm, you feel more rested than you have in a long, long time.

But after using Ambien for a while – admittedly for longer than the 7-10 days recommended by the FDA (Federal Drug Administration) and medical websites – I learned there are several downsides to using Ambien. First of all, you can develop tolerance to the medication through repeated use – which means it can take longer for the effect to kick-in and it may seem less effective if you’ve been using it for a long period of time. Also, according to the FDA package insert, you can develop a “drugged feeling” with use of around a month or more. But the most talked about issues with Ambien are what the medical community calls “abnormal thinking and behavioral changes”. This includes reports of “sleep-driving” and other behaviors reported while under the influence of Ambien, such as eating at night or having sex – with no memories of these activities in the morning.

risks-mixing-ambien-with-parenthoodSome of these odd sleep-behaviors can be comical. One woman found that she had painted her front door during the night, while another was experiencing unexplained weight gain that turned out to be caused by late-night Ambien-induced food binges (see this link). My hairstylist told me of a male client that “cut” his hair under the influence of Ambien. The result was terrible – with sections of hair cut so close to the scalp that it’s a wonder he didn’t badly injure himself. He was mortified and she had to give him a buzz cut to fix the problem!

However, other reports of Ambien side effects are much more alarming. There have been several reports of car accidents – most famously Patrick Kennedy’s 2006 crash – and people who wake up in police custody or the ER after Ambien-affected driving. Plus Ambien-related ER visits have skyrocketed in recent years, with women much more affected than men. Also a friend told me of her nighttime Ambien-fueled cooking sessions that resulted in bloody fingers from using her sharp kitchen knives under the influence.

But with all these issues, one thing really stood out for me….no one is talking about the risks of parents of young children using Ambien or medications like it. If you can sleep-drive and crash your car under the influence of Ambien, what’s to prevent you from taking your kid along? What about cutting your child’s hair or letting them help you “cook”? And how might your kids cope if an emergency happens and they can’t wake you? Even if these extreme situations may be rare, you might do or say some things you regret later. For example, I once took Ambien before putting my son to bed (remember that tolerance development I mentioned earlier??) and during reading time proceeded to explain how we needed to build a carousel in our bathroom! That might seem like a fun conversation for a toddler, but Elliott was old enough to know that Mom was behaving strangely….and it kind of freaked him out. Another time, I told him my iTunes password….I had no memory of it later, but new apps/games (granted, mostly free) started showing up on my phone after I let him play on it. His defense? “But Mom, when I asked you for your password, you just told me!” What can I say to that?

I’m in no way suggesting that people shouldn’t use Ambien. That is a personal decision between you and your doctor – and Ambien can really help with insomnia, which I well know is a very real and serious condition. Instead I think it could help if we (experienced Ambien users) started sharing the issues and challenges we’ve faced mixing Ambien use with parenthood and any advice we would have liked to have gotten when we started using sedative-hypnotics. So here is my attempt:

  • If there are two adults in the house, plan for only one to take a sedative-hypnotic medication on any given night – and communicate when you are taking one so the other person is alerted
  • For women, make sure you are taking the lower dose of Ambien recommended by the FDA in 2013 (5 mg for immediate-release rather than 10mg for men, and 6.25 mg for extended-release rather than men’s 12.5 mg) – women clear the drug more slowly than men and studies have shown more next-day drowsiness and driving impairment in women
  • Skip the Ambien if you’ve had any alcohol or have taken other medications that can influence the brain – like narcotic pain relievers (e.g. medications including hydrocodone or oxycodone) or other anti-anxiety and insomnia medications – these combinations are associated with increases in Ambien-related ER visits
  • Even if you are finding the Ambien is taking longer to work….don’t take it until you get into bed, especially if your kids are still up – you may be surprised the next morning by what you did or said!…(see earlier)
  • Consider telling your children that you will be very sleepy that night – maybe because you aren’t feeling well – so they shouldn’t bother you in the night unless it’s an emergency (we didn’t want to tell our son that mom was taking a medication to sleep, although I did when he was older and understood my health and sleep challenges)
    • The one Ambien/parent story I found on the internet was about a mom whose son threw up on her while she was sleeping because he wasn’t feeling well but couldn’t wake her (even though Dad was also in the bed!) so make sure your kids know to ask the other parent for help that night
  • If you are the only adult in the house, think about asking a close friend or family member to be “on call” if something ever happens when you’ve taken an Ambien – you can tell your children to contact them in the night if something serious happens and leave a note with the number somewhere obvious on an Ambien night
  • If you can, limit how often you take Ambien, possibly by alternating other non-hypnotic sleep aids or by using alternative therapies – I was able to drastically cut my use of insomnia medication through acupuncture treatments and mindfulness meditation (though I know this won’t work for everyone)
  • And, finally, be kind to yourself…using Ambien on occasion doesn’t make you a bad parent – being severely sleep-deprived can though!

About the Author

Audra is an experienced pharmaceutical marketing professional, aspiring writer, and mother of Elliott, a high-spirited twenty-year old. Frequently tired but never bored, she has a strong interest in public health fostered by numerous years implementing global oncology education programs as well as by her twenty-year crazy (wild? amazing?) adventure in parenting. She recently earned a Masters in Public Health to augment her expertise in health policy and health promotion. Audra is a founding member of the PedSafe Team


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