Have Insomnia? The Risks of Mixing Ambien and Parenthood

Last updated on June 24th, 2015 at 02:39 pm

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.

One 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.

Some 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!

Nine Simple Mommy Secrets to Minimize Sibling Jealousy

Last updated on May 30th, 2017 at 09:38 pm

I’ll never forget the time one of my kids accused me of one of the truly Deadly Mommy Sins: “Loving the Other Brother More.” To make things even worse, my girlfriend was the one to convey my youngest child’s feelings to me. “Did you know that your youngest, precious child thinks you love your second offspring more?” I can remember not only her words, but where she relayed them to me. They caused such angst. Oh the guilt, the shame, the humiliation! There are few crimes your child can accuse you of that make a mother feel more hurt and disgraced. And how could my son possibly feel I loved his brother more? I wracked my brain trying to figure that one. I’d always tried so hard to make things fair amongst my sons. After all, I went out of my way to make sure I showed up–and on time, at that–at the precise same number of their soccer games. I tallied the exact hours I volunteered in each of my children’s classrooms to ensure I gave equal time. I even checked my Daytimer to make certain each child had the same number of play dates. And now I’m accused of being an unfair mother! I was devastated.

A few sleepless nights I finally had my “Ah Ha Mommy Moment.” I realized that though I can try to make things appear even and equal for my kids, the fact is, it’s just plain impossible. Besides, even trying to treat kids equally is plain unrealistic: my three kids are as different as night and day just as I’m sure yours are as well. Our kids come packaged with different temperaments, interests, and needs. So we can’t drive ourselves too crazy trying to make things always fair. It just isn’t realistic. Besides, real life isn’t fair. It was my Reality Check and became an important Mommy Secret to remind myself. The truth is, as much as we try to make our kids feel equally loved, they are bound to accuse us of showing “favoritism.” It’s up to we moms to keep things in perspective.

The real secret here is to try and minimize conditions that break down sibling relationships that can cause long-lasting resentment. Here’s the bottom line: While some rivalry is plain unavoidable, mothers can discourage sibling disharmony by giving careful attention to how their household atmosphere is structured. Here are nine simple Mommy Secrets to guide you in minimizing sibling jealousy and boosting harmony amongst your kids:

1. Give yourself a reality check. Before you go beating yourself up, take a moment to seriously reflect on how you do treat your kids. A good question to ponder is: “If someone asked your child if you treat your kids fairly, how would he or she respond?” For instance: Does each kid feel like your favorite? Do you avoid comparing your kids in front of others? Do you provide opportunities for each child to nurture her special talents? Is there one thing you might do to change your behavior or interactions with your children to minimize their feelings of jealousy or rivalry?
2. Get in your child’s shoes. Pretend you really are in the shoes of the child who feels jealous. How would you feel if you were your kid? How would you act? Is his take on things right? If so, what will you do to change your relationship with this child so he feels just as special in your eyes? Write down your thoughts then commit to making that change happen.
3. Refrain from comparing behaviors. Never compare or praise one kid’s behavior in contrast to a sibling: it can create long-lasting strains. “Why can’t you be more like your sister?” “Why aren’t you organized like your brother?” All too easily, kids can interpret such comparisons as: “You think he’s better than me” or “You love him more.” It unfairly puts pressure on the sibling you praised and devalues your other child.
4. Listen openly to all sides. Listening fairly to your kids is a powerful way to convey that you respect each child’s thoughts and want to hear all sides: “Thanks for sharing. Now I want to hear your brother’s side.” The key is to build a fair relationship with each sibling so that he or she knows not only that you value each opinion and you’re an unbiased listener.
5. Never compare schoolwork. Kids should compare their schoolwork, test scores, and report cards only to their own previous work—never to the work of their siblings or friends. Instead of stimulating a child to work harder, comparisons are more likely to fuel resentment.
6. Avoid using negative labels. Family nicknames like Shorty, Clumsy, or Klutz can cause unfair family ribbings and fuel sibling resentment. “Don’t worry, he’s just the family klutz”-as well as become daily reminders of incompetence. These kinds of labels often stick and become difficult to erase, not only within but also outside your family as well.
7. Nurture a unique strength for each sibling. All kids deserve to hear from parents what makes them unique. Knowledge of that talent nurtures their self-esteem as well as setting them apart from their siblings. Ideally, you should nurture a different strength for each sibling based on natural temperament and interests. Once you identify the talent, find opportunities to cultivate and validate it so each child can be acknowledged for their strength.
8. Find special alone time with each child. One way to let each child feel treasured is by spending alone just with each parent. Capitalize on those individual moments as they arise: “Your brother’s asleep. Let’s just you and I go read books together.” Or make a date with each sibling to have special time just with you then mark it on the calendar. How frequently you meet is based on what’s realistic for your schedule: thirty minutes weekly, ten minutes daily, an hour every other week. Arrange for another adult to watch other siblings or choose a time when they’re gone. “Together” occasions could be: a movie, a walk, lunching at a favorite restaurant, kite flying, an ice cream outing, or just time alone. Then enjoy each other without siblings around.
9. Reinforce cooperative behavior. Don’t overlook one of the simplest ways to boost sibling harmony: catch them supporting each other. The moments may be few and far between, but when they do help, share, cooperate, and work well together, tell them you appreciate their efforts. They’re more likely to repeat the behaviors because they know that’s what you want them to do.

Now that you’ve learned the nine Mommy Secrets how will you use them to achieve long-term change? You might want to take a moment to write down exactly what promise you want to make to yourself and your family. For instance, which simple secret you will commit to doing within the next twenty-four hours to make a real difference in your family. Then don’t give up until you get the change you want.

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Dr Borba’s book The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries, is one of the most comprehensive parenting book for kids 3 to 13. This down-to-earth guide offers advice for dealing with children’s difficult behavior and hot button issues including biting, tantrums, cheating, bad friends, inappropriate clothing, sex, drugs, peer pressure and much more. Each of the 101 challenging parenting issues includes specific step-by-step solutions and practical advice that is age appropriate based on the latest research. The Big Book of Parenting Solutions is available at amazon.com

Annual Checkup Coming? Help Your Pediatrician be an Ally

Last updated on March 2nd, 2018 at 12:55 pm

I don’t know about others’ experiences, but as my son aged the role and benefit of our wonderful pediatrician shifted. She started out as the font of all child knowledge and mommy reassurance – being both a well-respected doctor and a mother of boys.  However, over the years, during his annual checkup, she stopped addressing most of her questions to me and began directing her attention to my son….asking him about aspects of his life like school, friends, exercise and nutrition.

Early on in this process I realized that he wasn’t always painting a complete picture of reality with his answers. Like how he said he regularly ate enough fruit and vegetables, brushed his teeth every day (true, but not always twice), and went to bed at 9:30 (yes, but when did he go to sleep??). And I sat there – wanting to be able to pass thought bubbles to our doctor so she would probe more!

I wanted her authority and influence on my son’s health behavior during these annual checkups – but not through my overt prompting. Kids start tuning out their parents at a certain age and I didn’t want his doctor to seem like an agent of parental control. This was a great concept in theory, but in practice accessing a doctor outside of a scheduled appointment can be like trying to meet the latest chart-topping pop star.

It wasn’t until I finally called her office for advice on this – and got to speak to a person – that I learned they were very familiar with this need to speak to and prepare the doctor before an older child’s annual checkup.  The approach our office uses to enable direct contact with the doctor is the same they offered when we first joined the practice with a newborn:  early morning phone time at the doctor’s home. Our pediatrician takes calls at her home each morning from 7 to 7:30am, which is great for new parents who don’t know whether they need to bring the baby in to see the doctor or just need some advice. But it never dawned on me that this approach could also be used to help my son’s doctor become a better ally.

It’s not the easiest process, I admit. First I have to even remember to make the call when I’m still waking up and engaged in morning chaos. A note on the kitchen counter usually helps with that. But the biggest challenge is all the other parents trying to reach her at the same time. Her number is constantly busy so I have to keep dialing and redialing to get through. But once I do, I always get results. Like this year, when I talked to her about my son’s habit of sometimes staying up very late (after we’ve gone to bed) to finish homework. I’m worried about his health – but I’ve become a broken record about the issue. So she took on the challenge and in our visit she got him to own up to how late he sometimes goes to bed – and then explained to him the concern in terms he might care about:  that as he is heading towards puberty, he needs more sleep if he wants to grow as much as possible because the body makes growth hormone during sleep. And what boy doesn’t want to be tall?

Not every pediatrician will do home phone time, but they should understand the need for parents to prepare them ahead of a checkup with an older child – and it makes it easier for them to do their job well.  Check with your doctor’s office to see what approach they have for this type of advance communication. And at a minimum you can ask to speak to the nurse or doctor alone at the start of your child’s next annual visit.

Tips for Protecting Your Kids from Child Abuse

Last updated on May 4th, 2015 at 11:38 am

Sleep and Other Tips to Help Your Child Beat Exam Stress

Last updated on August 29th, 2015 at 03:03 pm

Helping Your Child Overcome Their Fear of the Dentist

Last updated on August 29th, 2015 at 04:25 pm

Let’s face it: going to the dentist is not everyone’s favorite thing to do. Children especially tend to get extremely anxious when it comes to dental appointments. A big chair, a bright light, and someone with a mask poking around in their mouth with metal instruments is enough to make any child fearful and uncooperative during a routine check-up. It also makes for a pretty tough visit for the parent, the child and the dentist alike.

A dental visit doesn’t have to be an overwhelmingly frightening event though. There are many things that can be done to help calm your child’s nerves. A great way to help your child be brave when going to the dentist is by starting their visits at a young age. The younger they are, the more comfortable they will become with the routine of visiting the dentist twice a year. You can take your child to the dentist as early as their first tooth appears.

One of the best places to start preparing your child for the dentist is at home. Consider having a “practice” dental check-up by pretending to be the dentist and examining their teeth. This way, they have a better idea of what to expect. Another recommendation is to check out children’s books about the dentist at the library. Read to your child about the dentist within the weeks before their first appointment so that they have even more familiarity with the dentist office.

Parents who have a fear of the dentist themselves can often influence how their child feels about the dentist. Avoid using words that might frighten them even more, like “hurt,” “scrape,” or “poke.” Instead, use positive words and phrases like “strong teeth” or “healthy smile” when talking about going to the dentist. Tell them that the dentist is going to “look at their teeth and make sure they are healthy and clean.” Let your child form their own opinion about the dentist, but help reinforce why it’s good and important for them to go.

No matter how much you try to prepare your child, you should always be ready for a little bit of fuss. The dental team is likely very familiar with temper tantrums during a child’s appointment, so they may have some good ideas on how to help calm their nerves. Be patient with your child during the first few appointments, and continue to take them every 6 months. The more often they go, the more likely they are to be comfortable with the appointment. Besides, a healthy smile calls for routine visits to the dentist twice a year anyway!

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