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Women Must Take Less Ambien

Now hear this: Time to cut down on your Ambien.  If you're female, the findings are that Ambien is not metabolized in your system as quickly as it is if you are male.  And there's more, but mostly, this is the perfect time to reconsider your sleep ritual. Dr. Tracey Marks breaks it down.

The FDA has ordered Sanofi, the makers of Ambien to reduce the recommended dose of Ambien due to recent research findings that show women metabolize the drug slower than men and still have enough drug in their systems eight hours after consumption to impair driving.  These studies came from an FDA analysis of the clinical data on Intermezzo, another form of zolipem approved last year to treat middle of the night awakenings.

According to the FDA, there have been over 700 reports of car accidents related to sleep aids like Ambien over the past several years. 

Sanofi, the makers of Ambien have always been clear in their warnings that an individual should not take Ambien unless he has 7-8 hours to sleep.  The FDA believes that because women metabolize the drug slower, eight hours is not enough. 

Last year a Feb 2012 study in the British Medical Journal Online made an association between sleeping pill use and increased risk of death by various means (including motor vehicle accidents).

What does this mean for you if you take sleeping pills?  It means a change in how you take the medication.  You won’t be able to fall back on Ambien after you’ve decided you can’t sleep.  Instead you will have to carefully plan the time you take it to ensure you leave yourself at least eight hours of sleep time and likely another 2 hours before you need to drive. 

Let’s look at a practical example.  If you have to be on the road in the morning at 8am, you should not take Ambien after 10pm the night before.  If you are one for whom Ambien works within minutes, you now have a bedtime of 10pm.

So you are no longer able to roll out of bed and be in your car within 20 minutes of waking.  Maybe you haven’t been able to do that since college, but how practical is it for you to be awake for a couple of hours in the morning before you leave the house?  These are all things you must consider when deciding to take sleeping pills.

Sleeping pills can be very helpful in getting someone to sleep immediately, but that’s where their utility should end.  It’s always preferable to use behavioral interventions such as faithful adherence to good sleep-hygiene practices to achieve restful sleep.  You should also investigate a medical cause for your insomnia that may be reversible.

In my opinion, the trouble with Ambien and other sleeping medications is that people often become tolerant to the sedating effects.  That is, most sleeping pills don’t work forever.  There is the natural tendency to take a little more to get the same effect.   Higher doses increase your risk of having too much of the drug in your system when you wake.

One last note is that although the FDA has required these changes only for Ambien, all sleeping pills can cause morning sedation, particularly the longer acting drugs.  Pay close attention to the time you take the medication, do not combine it with other sedating medications (like benzodiazepines) or alcohol and talk with your doctor about how you should adjust your medication and dosage timing to suit your individual needs.