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Long term use of ambien for insomnia



Insomnia? Skip the Meds for Other Therapies Without Side Effects

10.15.2017 | Jessica MacAdam
Long term use of ambien for insomnia

Such long-term use has been associated with psychological addiction and a Prescriptions for Ambien declined from just above 3 million in.

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If he or she is up on the latest research, you’ll be cautioned to minimize the use of prescription and OTC sleep medicines. Instead, he or she may direct you to a sleep clinic or therapist (usually a psychologist or clinical social worker, not a doctor) who does CBT. If your sleep problems persist beyond 14 days or so, it’s time to see your doctor.

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If your insomnia has been triggered by a life event or by depression or anxiety — as is common — you’ll typically be referred to a counselor or psychotherapist. CBT involves, initially, 3 to 6 one-hour sessions. Related emotional and life problems will also be discussed, but usually just as they relate to your sleep patterns and troubles.

The problem is that both the prescription and OTC sleep drugs are intended for short-term use — a week to 10 days — but are being widely used over longer periods. An analysis by Thomas Moore of the Institute for Safe Medication Practices found, for example, that two-thirds of people taking zolpidem (generic Ambien) used it for weeks, months or even years.

But a 2015 Consumer Reports survey of 4,023 adults found a troubling trend: Of the 20% who took an OTC sleep aid within the past year, 1 in 5 said they took it on a daily basis and 40% said they used the drugs for a year or longer.

Bazil, MD, PhD, director of the Epilepsy and Sleep Division at Columbia University’s Department of Neurology. Diphenhydramine can also create psychological dependence, says Carl W. “The pills are not ‘addictive’ in the physical sense,” he says, “but there can certainly be a risk for a psychological dependency.”.

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And the FDA requires the package inserts to l consumers to see their doctor if insomnia persists for more than 2 weeks. The packaging on these medicines suggests they are “non-habit-forming” when used as directed — that is, for short periods.

These effects have been highlighted in numerous court cases surrounding fatal and non-fatal auto and other kinds of accidents. Such long-term use has been associated with psychological addiction and a heightened risk of morning drowsiness, falls and accidents.

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Various techniques are used. Typically, after a full assessment, you’ll be prohibited from watching TV in bed, coached to go to sleep and get up at the same time every day, and taught relaxation and meditation techniques. CBT aims to change the way you think about and approach sleep, and your habits of going to bed and getting to sleep.

Also, pay close attention to pill labels and, above all, avoid mixing narcotic painkillers with any kind of sleeping pill. Source: Consumer Reports.

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In addition, Moore’s analysis found that 1 in 5 people who took Ambien combined it with an opioid. That combination vastly increases the risk of dangerous side effects and even potentially fatal depression of the central nervous system.

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But they are still prescribed way too often. Here are some numbers, compiled from IMS Health, which tracks drug sales worldwide:. The good news: Prescriptions for these medicines are declining amid attention to their downsides and risks.

While that analysis focused on Ambien, the same problem likely exists for Ambien’s competitors Lunesta (eszopiclone) and Sonata (zaleplon).

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There are dozens of kinds, but the big sellers are Advil PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom SleepMinis, and ZzzQuil, from the makers of NyQuil. As for the OTC sleep drugs, they can hook you as well, according to medical experts and Consumer Reports.

Prescription and over-the counter (OTC) sleep aids are among the most widely used medicines. Their popularity has been spurred by aggressive marketing over the last decade — almost every adult knows what Ambien is — but also by changes in our culture that have disrupted good sleep habits (TVs, computers, smartphones, the Internet, etc.) and exacerbated things for people prone to clinical insomnia (work and life stress, economic displacement).

Never drink alcohol while taking them, and don’t take an extra pill to get back to sleep — doing either can worsen the drug’s side effects. If you still decide to take insomnia drugs, do so for only a few days at a time, at the lowest recommended dose.

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But for the past 2 decades, physicians and public health officials mostly went with the societal flow — acceding to the growing demand for and use of prescription and OTC sleep aids. Much has been written about this issue and the drugs themselves, with lots of hand-wringing and popular advice.

(More about CBT below.). Researchers contracted by AHRQ to probe all the recent studies on insomnia treatment found cognitive behavioral therapy (CBT) to be a more consistently effective way to combat chronic and intermittent insomnia — especially over the long term — compared with any insomnia or sleep medicine. The latest research to reach this conclusion comes from the Agency for Healthcare Research and Quality (AHRQ), a federal government entity.

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The AHRQ analysis found that CBT helps 70 to 80% of people with chronic insomnia — shortening the time people fall asleep by 12 to 40 minutes, and adding 20 to 45 minutes of total sleep time.

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And CBT is not restricted to people with chronic insomnia. In addition, a recent review of 37 studies involving 2,189 people found that CBT was effective in those with co-existing illnesses and psychiatric conditions, including alcohol dependence, depression, post-traumatic stress disorder, cancer, chronic pain, and fibromyalgia. Sleep specialists and clinics these days routinely use CBT to treat people who have intermittent bouts of insomnia as well.

The biggest benefit of all: No side effects or risks.

Also of concern: the “hangover effect”— impaired balance, coordination, and driving performance the day after you’ve taken the drug, heightening the risk for falls and accidents. That’s a problem for many reasons. Diphenhydramine can cause constipation, confusion, dizziness, and next-day drowsiness, according to the FDA.

That’s now beginning to change, and fast. More and more research and data show that these medicines are being abused, overused, and unwisely prescribed — and there are better solutions.

He derives some of his posts and insights from Consumer Reports Best Buy Drugs, a grant-funded public information and education program that evaluates prescription drugs based on authoritative, peer-reviewed research. Steven Findlay is an independent medical and health policy journalist and a contributing editor/writer for Consumer Reports.

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The active ingredient in all these drugs is diphenhydramine, a decades-old antihistamine used as a remedy for seasonal allergies. It works by blocking the histamine receptors in the brain that control wakefulness, so drowsiness is a side effect for most people.