Marc asked
I was in a car accident I went to the hospital a week afterwards after experiencing insomnia and anxiety. I asked about the insomnia and the doctor gave me a ten day prescription of generic Ambien 10 mg pills. I've avoided taking it so far. The doctor said only take it if you absolutely need to. I need a good night of rest, and I feel like I'm running out of options. What really worries me are the potential side effects and how they might affect my anxiety. I also have mild sleep apnea, which certain medicines can affect. Should I take the Ambien or not?
At a glance
- Ambien, at recommended hypnotic doses, is unlikely to cause respiratory depression.
- An important factor in the use of Ambien in those with sleep apnea is the type you have, obstructive or central.
- Studies show that it can reduce oxygen saturation in those with mild-to-moderate obstructive sleep apnea. This could worsen symptoms of fatigue and next-day grogginess.
- Ambien may be a beneficial treatment for central sleep apnea, and is recommended as a potential therapy option by the American Academy of Sleep Medicine (AASM).
Answer
Ambien (zolpidem) can (and has) been used safely in those diagnosed with sleep apnea, but is recommended to be used cautiously and only under the supervision/recommendation from your doctor.
Perhaps the most important thing to take into consideration is the type of sleep apnea you have (i.e. obstructive or central sleep apnea).
Ambien may actually help improve central sleep apnea, while data is conflicting on the its effects in those with obstructive sleep apnea.
The prescribing information for Ambien states the following on the matter:
References
- Updated Guidelines from AASM for the Treatment of Central Sleep Apnea Syndromes. AAFP
- Twelve months of nightly zolpidem does not lead to rebound insomnia or withdrawal symptoms: a prospective placebo-controlled study. PubMed
- Improvement of Idiopathic Central Sleep Apnea with Zolpidem. JCSM
- Effects of opioid, hypnotic and sedating medications on sleep-disordered breathing in adults with obstructive sleep apnoea. PubMed
- International Classification of Sleep Disorders – Third Edition (ICSD-3) (Online). AASM
- Clinical Guideline for the Evaluation, Management and Long-term Care of Obstructive Sleep Apnea in Adults. AccessFDA
- Sleep Apnea Information Page. NIH
- Ambien Prescribing Information. AccessFDA
