I turn 65 shortly, and yesterday I got a note from my doctor: I will no longer be allowed to use Ambien. Nor any other sleep med. Why? Because they......
......make you drowsy.
I'm not joking. All sleep meds carry a risk of keeping you drowsy longer than intended, and in old folks that increases the risk of fractures when we get out of bed. Plus there are the very rare but colorful side effects of meds like Ambien, including sleep eating and sleep driving. This practically never happens, but it happens just enough to produce some lawsuits. So no sleep meds for us senior citizens.
The only exception is ultra-low-dose doxepin, a 50-year-old tricyclic antidepressant which, according to clinical studies, does not help you get to sleep. It only keeps you asleep once you finally nod off on your own.
You can probably imagine my excitement about this.
Yikes. Nothing to counter the Evil Dex, if you ever have to go on it again.
I recalled Ken Gillman ("psychiatrist and clinical neuropharmacologist") saying that doxepin is an extremely potent antihistamine, but "I don't believe it has any antidepressant effect whatsoever."
Antidepressants are also implicated in dementia, so not a huge loss.
Why not melatonin?
Or weed gummies?
Take CBD to-night and sleep.....
Deep and restful, sleeep, sleeep,...sleep!
Melatonin works well for me most of the time. But only if you take the form which dissolves in your mouth (sublingual). Swallowing a pill makes it go through your stomach, and God knows what your stomach can do to the melatonin. Under the tongue and it gets directly into your bloodstream.
So I take it as I get into bed. It seems to work in about 15 to 30 minutes.
Of course, it is nice to have an Ambien backup on those nights that it doesn't work.
I don't even need the whole pill.
I smash them into small chunks and slivers and take whichever chunk or sliver seems the right size for the evening, usually the smallest.
As someone a bit over a decade behind you, I appreciate the heads up.
Youngins get all the good drugs.
What! That is ridiculous, and I am outraged for you. It is not healthy to not get sleep. Is this a law or is it something less dystopian? Say, Medicare won't pay for it, but you can still buy it on your own.
i'm guessing that getting the 'script is the problem.
Better buy in bulk before I hit mine in a couple of months.
we're all looking forward to some amazing astro shots
I got the same message from my Doctor about a year ago. He started me on Trazadone. It has been beneficial, but it's definitely not at the same level as Ambien.
Trazodone worked for me for well over 10 years. Then it just stopped. Was great while it lasted.
Making you drowsy quicker is not the same as getting good sleep. You should read Walker's book "Why We Sleep" for a full explanation and for other suggestions going further.
Benadryl
Vastly less effective than prescription meds.
Benadryl may help with falling asleep, but doctors say that the resulting sleep quality is poor.
Long term use of Benadryl increases risk of dementia.
I am sure that sleep deprivation will be healthful side effect of no Ambien. So now you can fall asleep at the wheel, which is so much safer than Ambien rebound.
Maybe you can find another doctor.
Just remember, there are Things They Have To Say To You because The Lawyers Say So.
From Germany I get a sleeping pill called "Hogard Night." I take half a pill, sleep great, especially good for jet lag, without any real drowsyness in the morning.
It appears that what you are referring to is doxylamine, one of the old sedating antihistamines. (Unisom)
Doxylamine does work very well. I would also just note as a 74 year old that a good nights sleep at my age doesn't compare to the good nights sleep I routinely had as a 20-30 year old. Everything is relative.
Try diphenhydramine a antihistamine also. Available OTC. Seems to work for me. Very safe.
Diphenhydramine gives poor sleep quality and long term use increases risk of Alzheimer's and dementia. So not very safe.
"Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less."
https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667
I looked that up too after seeing Zergus's comment. I don't get colds particularly often, but when I do I find there's nothing quite like a long, deep sleep to help the body recover, and for this reason I'm partial to concoctions like Nyquil or A-S Cold Medicine PM.
Anyway, long story short, I believe that research indicates the dangerous use level is every day for three years. So I feel I'm safe.
Doxepin and a gummy. I'm telling you, man! Do some chemistry!
Ask about low-dose Seroquel (Quetiapine).
Solitaire on a phone until Sleeeep…
cspan ...
Welcome to OA Kevin. Hang in there.
So no more warm milk?
Can't you get a second opinion? And perhaps something other than Ambien is safer? Someone I know used to take Lunesta. I tried it once or twice (I know, criminal me!): I thought it was amazingly effective and left me with absolutely no grogginess the next morning.
I’m 68; my doctor won’t prescribe Lunesta for me for the same reasons Kevin’s doctor won’t prescribe Ambien.
So, sounds like older folks with sleep issues are basically told to fuck off.
Who would have guessed we'd need fake IDs in our dotage?
That Lunesta sounds promising...They keep outlawing all the Meds I had come to love, early chloral hydrate, then the wonderful Quaaludes that absolutely everyone took that could get their hands on...sigh, wonderful nights gone. I've tried Xnax, as well as marijuana, (which I really just never liked), and for the past bunch of years I've been taking a very old, but now generic, Hypnotic...it works well enough, though not always, especially if I am working hard on an all nighter... but with camomile tea it is better, but better yet with a gin and tonic.
Be that as it may, I have only delved into this topic in some depth because picking up my Temazepam prescription this week at CVS, my pharmacist lectured me pretty hard on the dangers of this drug...I said, "If you come and do my work, I'll give them up," and I laughed. She did not.
I monitor my sleep daily....we all need all our deep sleep to avoid Alzheimer's.
Or so they say.
Sleep is important, I would ask your Doctor's reason for his edict...it may be good, (interacts with other drugs), or it may be bad, (he's just covering his backside with too much caution).
Best Wishes, Traveller
I'm just amazed by all the folks who seem to rely on meds to sleep.
Google "what's it like to suffer from insomnia" and read some people's stories. Your amazement may decrease.
Okay. But I typically have to get up 3-4 times every night, so maybe I'm just better at falling asleep.
I'm like you--rarely have trouble falling asleep, get up a few times during the night and fall right back. My husband would say he never saw someone fall asleep so quickly. I told him I sleep the sleep of the rightous. But some family members do have trouble sleeping, and have been using CBD, or CBD with meletonin.
Have you ever tried the sleep hygiene protocol? It has worked for me when I encounter insomnia. I've used the one from the Cleveland Clinic - https://www.clevelandclinicwellness.com/pages/GoToSleep.htm It costs $40. The VA has a free app - https://mobile.va.gov/app/insomnia-coach.
Your doctor just has to tell you that because his insurance requires him to.
Until you start waking up in your pajamas in a McDonalds parking lot with a happy meal in your lap you're fine.
In a graduate-level psychophysiology course many years ago, we read William C. Dement’s Some Must Watch while Some Must Sleep. One of the things I remember from the course was that no medication in use at that time induced anything like normal sleep patterns, evidenced by EEG changes. I haven’t followed the research since (not my field of practice); I’m curious to know if any newer meds are better in this regard.
Well, "Zolpidem and zaleplon suppress REM sleep less extensively than benzodiazepines and thus may be superior to benzodiazepines for use as hypnotics."
(a bit from the latest edition of Goodman and Gilman)
Does this bar you from all prescription sleep meds? I recommend you ask about orexin antagonists. There are are few on the market.
I don't think this is an edict from the government or the physician's personal opinion. It sounds like it is forged by the standards of your health care provider organization that makes clinical decisions based on data from studies. Although there are plenty of options (none of which I would like, especially those with anticholinergic properties - think aging prostate and dementia risks) a reasonable physician would weigh risks and benefits based on individual characteristics of the patient. If other options don't work and your insomnia is impairing you, you should have the option to restart Ambien. A healthcare system that doesn't allow for override of clinical guidelines is a weak system.