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Can Ambien really cause sleep-driving and sleep-eating?

Yes. But all insomnia drugs pose some risks—which is one reason you're usually better off with nondrug measures.

Published: January 31, 2014 11:00 AM

Q. I’ve heard a lot lately about the sleeping pill Ambien causing odd side effects, like sleep-driving and sleep-eating. True?

A. Yes. Ambien, Lunesta, and other newer insomnia drugs carry a warning that people who take them might attempt to drive or eat while still asleep with no memory of doing so. And long-acting Ambien CR (and generic) stays in your body so long it could impair your ability to drive the next morning. In fact, a number of celebrities—including Kerry Kennedy, Eminem, and Tom Brokaw—have reportedly blamed Ambien for causing impaired driving, memory lapses, and other problems. And several people accused of impaired driving, and worse, have even used the “Ambien defense” in court cases.

Looking for the best sleep aid? Read Sleeping pills for insomnia: Which ones work best?

While those side effects are rare, sleeping pills can cause more common problems, including diarrhea, dizziness, headache, and nausea. They can even worsen your sleeping problems when abused, misused, or taken too often.

A better option for chronic insomnia—three or more nights a week for months—is behavioral therapy. Some studies suggest it’s more effective than insomnia medications. That involves getting help from a therapist to learn a new set of sleep behaviors. For example, you might be directed to get up at the same time every day and learn relaxation techniques and mental tricks to help you get to sleep.

If you’ve only had insomnia for a night or two, reassess your sleep routine before turning to medication. Are you watching TV or using computers, tablets, or phones in bed? That can make it difficult to fall asleep, so switch them off long before you hit the sack. If you drink alcohol or caffeine, take your last sip at least 3 hours before bedtime. A comfortable mattress, covers, and pillow can also help. And make sure your bedroom isn’t too noisy, bright, or hot.

If those steps don't work and you want to try a medication, Consumer Reports Best Buy Drugs report on insomnia drugs recommends that most people start with short-term use of an over-the-counter sleeping aid, such as diphenhydramine (Nytol, certain Unisom products, and generics), or doxylamine (Unisom SleepTabs and generic). If your sleep problems persist, talk to your doctor about zolpidem, the generic version of Ambien. We think it’s the best initial prescription option because of its efficacy, relative safety, and low price. Just be careful to use as low a dose as possible to help reduce the risk of side effects. And don’t take sleeping pills—prescription or over the counter—for more than seven nights.

If you are 55 or older, avoid sleeping pills unless absolutely necessary. Older people have a higher risk of side effects, such as dizziness and sedation, which can lead to falls and hip fractures.

Steve Mitchell

Editor's Note:

This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multi-state settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

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