Tuesday, October 09, 2012

Insomnia, Ambien and Me

I've had insomnia, on and off, since I was 5 years old.  Also had issues with depression and, at times, anxiety.  Been on and off of Prozac a few times, but not in this millennium.  Started having really chronic insomnia about 10 years ago when I was 45.  Went through temazapan and something else - both stopped working within months.  The one time I took Lunesta, it made me sleep much less.

In the meantime, I went from working full time to working part time to getting fired from a contract job because my concentration was so poor.  I work occasional odd jobs and do a lot of volunteer work.  Luckily, my husband has a job, but I'd really like to be able to work full time again.

In early 2008, I got involved with a medicine sleep study at the University of Pittsburgh, run by Dr. Douglas Moul (now of the Cleveland Clinic).   I spent three nights getting my sleep recorded and observed.  While it is frequently assumed that the sleep problem of all fat people is sleep apnea, I do not have it (which is good because I know I could never sleep with a CPAP machine). They found no reason for my persistent insomnia at all.  The only symptom they observed was that my blood oxygen decreased slightly just before I woke up.

I was put in a randomized group and given either a mystery drug or a placebo.  Within days, I was sleeping about an extra half hour to hour a night without any side effects.  Eight weeks later, I found out I was in the Ambien group.

Not that Ambien solved all my problems, but any extra sleep was very helpful.

So, since I wasn't having any side effects, I stayed on Ambien.  Every few months, I'd take an Ambien vacation where my sleep would drop to 2-3 hours from the 5-6 hours I'd get on Ambien.  So I'd go back on it.

Over time, though, I was getting less sleep on Ambien.  After 4 1/2 years on it, I finally took my last Ambien a month ago, at a time when I am unemployed, walking 2-4 miles a day, not drinking anything caffeinated and drinking maybe a beer or glass of wine a day.

Other than the insomnia being worse than ever (never sleeping more than 2 hours at a time), I feel OK.  No depression, just frustration.  I have tried Melatonin and it does nothing for me.  Ditto Benedryl.  Ditto Valerian. Ditto a white noise machine. Ditto a variety of specialty pillows. Ditto wearing orange safety glasses for a bit in the evening to cut out "blue light" (though I'm still giving that odd trick a try). Ditto buying a high-end mattress 10 years ago after 17 years of a water bed. Ditto not having a phone in the bedroom. Ditto...well, you think of any odd sleep trick and I've probably tried it over the last 10 years.

I do break down and take Nyqil once a week as that helps a little. Sometimes, having some tuna as a snack in the evening seems to help due to tryptophan. 

The only side effect (other than sleeplessness) from getting off of Ambien I've had is craving sweets.  I'm walking enough that I haven't gained any weight, but I'm currently not loosing either. Ambien was also a very slight appetite suppressant for me and helped me lose about 30 pounds while I was on it.

The insomnia I'm having now is somewhat different from the insomnia I was having pre-Ambien.  Ten years ago, I'd sleep 3-4 hours, wake up for 2 then, sometimes, sleep for an hour.  Now, It takes me an hour to fall asleep, I wake up 4-6 times a night and I haven't slept for more than 2 hours at a time in over a month.

During the day, it is pretty much the same as when I was on Ambien.  Some days, I get a lot of things done.  Other days, I get very little done.  My concentration is, generally, a little better when I can concentrate, so that's a good sign.

So, during a particularly bad bout of insomnia tonight, I went to our computer and looked up "Ambien withdrawl."  I ran into some pretty bad horror stories.  I'm having a somewhat different experience than many.  I don't feel depressed, suicidal or confused. I'm just very tired.  The fact that my insomnia is so different means that I agree with the point many of have made - Ambien can alter the sleep receptors.  I never had any of the bad side effects of Ambien people mention - no sleep walking, no sleep eating - other than not remembering dreams.  And I'm still not dreaming. I did have those odd "shocky" feelings at night sometimes, but those are also reported by menopausal women who aren't on Ambien.

The root cause of my insomnia is probably due to estrogen.  My mother had terrible insomnia in her 40s, but it got better in her 50s, and she said her grandmother had the same experience.  So I'm hoping, now that I'm through menopause as well, that that will also help get my sleep back into some sort of normal pattern.

But, it turns out that a few people who had warned me about Ambien were right - it is addictive and it can change your brain in ways you don't expect.

For a lot of discussion on Ambien addiction/recovery, see http://www.topix.com/forum/drug/ambien/T8MMMFNQIK6VHJOV6.  I only wish I'd started reading this area five years ago.

PS (10/28/12): No Ambien for nearly 7 weeks and my sleep is more disrupted now than it was before I took Ambien. Very annoying. Melatonin does nothing. Nyqil helps a little but I only take that one night a week. And now, there's a link between taking sleeping pills like Ambien and cancer.

PPS (3/15/13): No Ambien in over 6 months. Sometimes, I'm sleeping up to 3 hours at a time once during the night, which is a gradual improvement. I generally get about 5 hours of sleep a night with one or two brief wake-ups, but some nights get only 2 or 3 hours of sleep for no reason at all. On the down side, I've gained about 15 pounds since September, but the carbohydrate cravings are getting better so I'm being more "mindful" about my eating. I rarely drink soda (don't have any at home) but sometimes have Diet Coke or mocha drinks when I'm out. Still averaging 2 miles of walking a day. Am writing a little more some days.