What Sleeping Pill Works Better Than Ambien
Sleepwalking, sleep-driving, and sleep-using-a-stove are not things that you want to do. Therefore, theU.S. Food and Drug Administration on Tuesday announced that eszopiclone, zaleplon, and zolpidem will now have to include "boxed warnings" of such possible side effects.
If you think that these three things sound like Klingon language, they aren't. The FDA has no purview over Klingons. Instead, these terms are actually generic names for three types of popular sleep medications. You may have heard of Lunesta, which is eszopiclone. Sonata is zaleplon. Zolpidem goes by the names of Ambien, Ambien CR, Edluar, Intermezzo, and Zolpimist.
The FDA is concerned that these medications may in some cases result in "complex sleep behaviors." In this case, a complex sleep behavior is not sleeping in Iron Man pajamas or having far too many pillows on your bed. It is unknowingly engaging in activities that you normally shouldn't be doing while asleep.
An FDA review of the FDA Adverse Event Reporting System (FAERS) database found 62 cases of serious injuries from complex sleep behaviors after people took eszopiclone, zaleplon, or zolpidem from December 16, 1992, to February 27, 2018. A review of the medical literature revealed four more cases reported from December 16, 1992, to March 13, 2018. Deaths occurred in 20 of these 66 cases. Of the ones that survived, 46 suffered serious injuries. People did all kinds of things, ranging from falling to crashing cars to shooting themselves to committing suicide in various ways to drowning to burning themselves to killing someone else. No, these weren't all just simple walks in the park, although that can happen. In most cases, the patients had no clue what they were doing while asleep, until, of course, someone told them after they awoke.
Patients took zolpidem in 61 of the 66 cases, whereas they took eszopiclone in 3 and zaleplon in 2 of the cases. The FDA did add that zolpidem is much more commonly prescribed than eszopiclone and zaleplon.
Based this review, the FDA indicated the following: "As a result, we are requiring a Boxed Warning , our most prominent warning, to be added to theprescribing information and the patientMedication Guides for these medicines. We are also requiring a Contraindication , our strongest warning, to avoid use in patients who have previously experienced an episode of complex sleep behavior with eszopiclone, zaleplon, and zolpidem."
Note that the boxed warning will not include "making a bust of soccer star Brandi Chastain that looks nothing like Brandi Chastain":
Artist now blaming Ambien for the Brandi Chastain bust. pic.twitter.com/hDuMkc7bAC
— Alex Kaseberg (@AlexKaseberg) May 30, 2018
In the announcement, FDA Acting Commissioner Ned Sharpless, M.D. said the following:
We recognize that millions of Americans suffer from insomnia and rely on these drugs to help them sleep better at night. While these incidents are rare, they are serious and it's important that patients and health care professionals are aware of the risk. These incidents can occur after the first dose of these sleep medicines or after a longer period of treatment, and can occur in patients without any history of these behaviors and even at the lowest recommended doses. Today's action is an important step in our ongoing effort to call more attention to these critical safety issues and serves as an example of our ongoing commitment to ensuring that patients and health care professionals have the information they need to make informed treatment decisions.
As Sharpless indicated, these behaviors could happen the first time you take the medications and on any dose. Therefore, if you decide to try Ambien once, don't be too surprised if you awake next to a bust of someone who does not look like Brandi Chastain.
Of course, Sharpless did indicate that serious incidents after taking these three types of medications are rare. However, many complex sleep behaviors may go unreported because, after all, you are asleep when they happen. Even when someone else is witnessing your behaviors, he or she may not necessarily report them to the FDA or write up a medical case report, submit it to a scientific journal, and get it published. (If your friend is following you around just to get material for medical case reports, that person may not really be your friend.) Moreover, it isn't clear how frequently sleep medications may lead to behaviors that aren't necessarily life-threatening but could be health, reputation, relationship, or work threatening. For example, someone once sleep texted me after taking Ambien. And, no, I am not going to tell you what she said.
Even if more studies were done to determine the overall risk of different complex sleep behaviors after takingeszopiclone, zaleplon, or zolpidem, every person and apparently every time you take the pills may be different. Even if you have been taking one of these medications for a while without incident, could this be the one time that you sleep-while-making-waffles? What precautions, then, should you take?
First of all, sleep medications should never be the first option when you have trouble sleeping. Always opt for practicing good sleep hygiene first. This doesn't mean taking a bath before you go to bed, although being covered in mud head-to-toe may prevent you from falling asleep. The National Sleep Foundation defined sleep hygiene as "a variety of different practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness."
Good sleep hygiene includes being careful what you eat, drink, or smoke (such as spicy foods, carbonated beverages, caffeine, and nicotine) close to bedtime, limiting daytime naps to 30 minutes, and getting enough exercise and light exposure during the day. Of course, exercise too close to sleep time can keep you awake so no Riverdancing right before you get into bed. Make sure you find ways to relax before bedtime. For example, don't read emails or tweets that may aggravate you. Have a personalized routine that will put your mind and body at ease. Keep your sleep quarters comfortable. For many, that means relatively cool at 60 to 67 degrees Fahrenheit. And make sure you turn off that strobe light and disco ball in your bedroom when it is time to get some shut eye.
Secondly, don't always stress about getting a good night's sleep. Nearly everyone has trouble sleeping here and there. So if it is an occasional problem, you can always stay up binge watching Charmed. It may be better to feel a bit tired the next day than unconsciously making busts that do not look like Brandi Chastain. Difficulty sleeping is only a problem when it is recurring or really interfering with your life.
If you do continue to regularly struggle to get good sleep, see a doctor. Again, medications should be more of a last resort. Do not take sleep medications without the advice and supervision of a doctor. A real doctor. A competent doctor. A caring doctor. Moreover, a medical condition may be affecting your sleep, so he or she may want rule out some of these possibilities.
If you do find yourself having to take eszopiclone, zaleplon, or zolpidem, take precautions. Tell your partner or whomever may be sleeping near you that you are taking the medication. If someone is sleeping in your bed and you do not know the person, ask the person who he or she is before telling that person anything. Properly store and secure any items that may be dangerous and easily reachable while you are sleeping. If you do exhibit any complex sleep behaviors, tell your doctor immediately. You don't want to sleep on anything that may end up harming you in the future.
What Sleeping Pill Works Better Than Ambien
Source: https://www.forbes.com/sites/brucelee/2019/05/02/fda-here-are-the-new-warnings-about-sleeping-pills-like-ambien-lunesta-sonata/