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An early ad campaign for Ambien used a basket of sleeping Golden Retriever puppies as a metaphor for the drug’s gentle effects. The canine face of my experience with it, an ill-at-ease Shiba Inu watching me the morning after a bender, tells a very different story.
Here's what I have to thank Ambien for: Blurry vision. Forgotten conversation. Twelve stitches. An apartment fire.
I was prescribed Ambien on and off for years. I’m well versed in both its efficacy and in the dangerous progression of its side effects. This is the same drug that, in 2009, almost caused Jack Nicholson to drive his car off a cliff and that recently sent Tom Brokaw to the hospital after he babbled and slurred his way through a morning news show. Even Charlie Sheen, without whom the word “excess” might not exist, has called Ambien “the devil’s aspirin."
As we’re starting to better understand the drug’s physical risks, we shouldn’t ignore a very different and equally dangerous side effect, and that is what long-term Ambien use can do to one’s emotional well-being. I recently spoke with a friend who lost her sister to suicide. While being treated for depression, her sister was prescribed Ambien to address her insomnia. She hated it -- she confessed to being addicted to it, and it heightened her depression. My friend strongly believes that Ambien was a significant factor in augmenting the disease that eventually cost her sister her life.
According to the National Sleep Foundation, insomniacs are four times as likely to suffer from depression as the rest of the population. I fall into this category, and I know that no amount of antidepressants and aerobic exercise can compete with the mood-altering effects of Ambien. I also know how appealing even the illusion of sleep can be, though, and how people can continue to take the drug while heeding the warnings of other users.
As best I can recall I’ve always had insomnia. I still do, but it is not as bad as it once was. In my younger days it manifested as an inability to stay asleep past a certain point; by the time I was in my twenties, I couldn’t fall asleep at all. I’d be wide-awake and unable to do anything productive with the time, like read or write, or clean my apartment. My mind and body were exhausted but something in me fought sleep. Somehow I’d manage to function the next day, though my synapses never fired as quickly as I wanted them to, and I’d feel spacey, punch-drunk. I experimented with various sleep aids to different results; none were foolproof and all left me sluggish the next day. I tried all manner of natural remedies, Valerian root, Melatonin, herbal concoctions from Chinatown. I fielded well-intentioned advice of warm milk and chamomile tea. I did yoga. I took Benadryl. Nothing helped.
Finally a doctor prescribed Ambien, the latest “it” drug, and I found my miracle. I fell asleep quickly and woke, while not refreshed, aware that I had slept. I thought that was the point, but Ambien’s agenda is far more complex.
What you’re supposed to do is take a pill 30 minutes before you want to fall asleep and get right into bed. This is a lot to ask of a hardcore insomniac, for whom the wee small hours are best spent dabbling in superfluous activity until the point of exhaustion -- which can take hours, sometimes days. Lying in bed is the enemy, and the insomniac fights it. However, empirical evidence suggests that staying awake on Ambien makes one do “crazy” things and then swiftly forget them. It is classified as a sedative-hypnotic and is said to simulate a dream-like consciousness for the user who stays awake on it; in fact, trying to describe one’s experiences on Ambien the morning after is a lot like trying to recount a dream, flashes of images and snippets of conversation that may or may not have taken place.
In the early stages of my use, Ambien would take effect swiftly and euphorically. Time bounced around and my vision grew blurry. Then came the phone calls; my close friend from work was the unwitting recipient of many of these.
“You know you called me last night again,” he’d say, with the same bewildered look that my dog gave me in the mornings.
“Yep. You were on ‘Bob’s’ roof and people were coming by for a party. You called to invite me.”
“Nice guy, though, your imaginary friend.”
As common as these morning-after conversations were, the prospect of whatever sleep I did get outweighed the occasional lapse of reality. But soon everything that had been good about Ambien ceased to exist and its bad effects got worse. I built up a tolerance for it and, incredibly, a doctor I saw at the time increased my dosage. Ambien is usually prescribed in 5- and 10-milligram pills; by the end of my tenure, I was taking 20 milligrams a day. This doctor knew that I drank wine, and that, like many of my fellow travelers, I was inured to its sedative effects. So while I would avoid taking Ambien on nights that I “went out drinking," it was not at all unusual for me to have a couple of glasses of wine with dinner and take the medication at bedtime.
I didn’t become a regular user until 1999, when I went through my first major breakup, one that involved my moving out, paying two rents for a couple of months -- a futile attempt to assuage guilt -- and waiting out the first lease to reclaim my furniture. Sleep was not an option.
A dear friend had just separated from her husband and, armed with her own Ambien prescription, stayed with me for a few weeks. We were kindred spirits navigating the wreckage of our pasts amid a bleak, bleak version of the present: our furnishings were a television set, a queen-sized air mattress, an inflatable couch with a slow leak, and a professional set of kitchen knives. This friend is an excellent cook and she’d call during the day with menu ideas and wine suggestions. In the evenings, we’d inflate the sofa and watch Felicity reruns over sumptuous food and cheap wine. After dinner, when most of the couch had sunk to the floor and we’d run out of lamentations, we’d pop our Ambien, crawl to our inflatable bed and have fascinating dreams that were quickly forgotten. This is how we got through very dark days.
Ambien made me do incongruous things that I’d have to piece together the next day from physical evidence -- half-eaten orders from the 24-hour diner, packs of cigarettes I didn’t smoke, receipts for products I’d ordered online. Through divine intervention or dumb luck, I escaped fairly unscathed from situations that could have had dire consequences, and this was largely because I was not alone during these incidents. In the height of my Ambien use I went through a phase of feeling particularly depressed, which is not at all surprising. I came to rely on my friends, some of whom were between relationships and apartments, and so I often, gratefully, had overnight guests.
One night, while I was still alert enough to know what was happening, I tripped over the dog and split my chin open. It was a fairly small cut -- at least in terms of surface area -- and I knew that by the time I got anywhere to have it looked at, I’d be fully entrenched in the world of imaginary friends and forgotten patty melts, so I waited. I got twelve stitches the next day.
On another occasion, my overnight guest had gone to sleep while I stayed up with my Ambien-addled mind, doing whatever I did in this state, probably flitting around the room, putting electronics in the fridge and talking to the dog. I lit one of the cigarettes I didn’t recall buying and threw the match into the kitchen trashcan. The flames that shot out moments later were mesmerizing -- so much so that I wanted my friend to see them too. One stern lecture and new fire extinguisher later, I had to face the fact that Ambien had become a problem.
As harrowing as these experiences were, the most compelling reason to stop taking Ambien was its effect on my state of mind, the layers of depression that it left with me. I no longer take it, though I can’t say I never will again; I have a much more ethical doctor now, and he has prescribed it for me to get through very short phases of especially ill-timed insomnia. I try to practice what one doctor calls “sleep hygiene” these days. I drink less, I exercise more, and I do get decent sleep from time to time. I’ve come to realize that unadulterated exhaustion beats drug-induced sleep any day.
Still, I’ll probably always have the Ambien junkie’s mindset, and now that I know through much trial and extreme error how to properly use it, I can justify taking it from time to time to combat sleeplessness. But the most important lesson that it took me a while to admit is that it is anything but a miracle drug. It is at best a short-term solution to a long-term problem, at worst the transference of one untenable situation to another. There is still much work to be done in the field of sleep disorders. And there’s much work that I can continue to do to develop better sleep habits. In the words of Robert Frost:
I have promises to keep
And miles to go before I sleep
And miles to go before I sleep.