The United States seems to have trouble getting to sleep. With our fast-paced lifestyles and high rates of anxiety, millions of people struggle with sleep disorders that no memory foam sleep surfaces can solve. Getting enough sleep (around eight hours) improves both physical and psychological health and sets the tone for your entire day. However, the U.S. Centers for Disease Control and Prevention (CDC) reports that as many as 35 percent of American adults get fewer than seven hours each night.
This is partly because of the prevalence of insomnia, which is the most common sleep disorder, characterized by trouble falling asleep. With so many people suffering from insomnia, anxiety, and other sleep disorders, the prevalence of anti-anxiety sleep aids is understandable.
Since the late 1800s, we’ve been using medicinal sleep-inducing substances like barbiturates and benzodiazepines to treat sleeplessness. Ambien is among the most popular sleep inducing medications and it belongs to the newest class of prescription sleep aid medications: Z-drugs. Barbiturates and benzodiazepines have been found to cause a variety of adverse effects including dependence, addiction, dangerous withdrawal, and overdose. Now, studies are finding that Z-drugs have some of the same dangerous side effects, especially when they are mixed with alcohol.
Alcohol can react poorly with a plethora of pharmaceutical drugs but mixing it with sleep aids can be deadly. Learn more about the risks that come with mixing Ambien with alcohol.
Central nervous system (CNS) depressants are a class of drugs that suppress nervous system activity and create relaxing and anti-anxiety effects. CNS depressants include sedatives, tranquilizers, and hypnotics. The most common recreational drug in this category is alcohol. CNS depressants work by altering chemical messaging in the brain. They don’t directly introduce chemicals that cause sedation. Rather, they introduce chemicals that bind to GABA receptors and increase the efficiency of naturally occurring GABA. These are the chemicals that are designed to calm you down, induce sleep, and ease anxieties naturally.
Overuse of these chemicals can lead to tolerance, which is when your brain gets used to the presence of the CNS depressant and starts to counteract it to balance brain chemistry. After a long period of use, you may become dependent, which is when your brain stops producing its own chemical depressants naturally and begins to rely on the foreign substance.
As a CNS depressant, Ambien can be exasperated by the effects of alcohol. When you take an Ambien, it doesn’t immediately induce sleep. Rather, the effects of the GABA receptor cause you to relax, eases anxieties, and slows down your nervous system. This can cause a sedated state that’s between sleep and wakefulness. Even powerful sedatives cause something more like a coma than true restful sleep. However, with your nervous system relaxed, your brain should kick in with natural sleep and rapid eye movement, or REM (deep sleep where healing occurs). But, alcohol suppresses REM sleep, causing you to spend more time in the sedated coma state and less time in restful sleep.
During sleep, your brain tells your body to remain still. This allows you to dream without acting out all of the physical movements that occur in your mind. However, if you are in an Ambien-induced state of sedation and true sleep is stopped by alcohol, your circadian rhythm may be affected in a way that is similar to people who suffer from somnolence, or sleepwalking. Ambien has been observed to cause episodes of sleepwalking, sleep-eating, and even driving. In one case study, when all three of these were occurring, a patient stopped using Ambien and the sleep activity stopped along with it.
Sleepwalking is often painted in a humorous light on TV and in movies. But it can lead people to serious injury and even death if left untreated. The risk of auto accidents, dangerous falls, and even hurting others is increased by frequent sleepwalking.
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Abusing Ambien on its own can potentially lead to an overdose, in which your nervous system is suppressed to dangerous levels. The result can be excessive sedation, dizziness, slowed breathing, hypoxia, coma, and death. When combined with alcohol or other CNS depressants, the risk of experiencing a fatal Ambien overdose is increased. Because both substances work on the same receptors in the brain, taking them together can cause compounding effects where the receptors are sent into overdrive. Studies show that people who misuse Ambien with alcohol are more likely to require emergency services and intensive care.
In fact, many of the recorded cases of Ambien overdose involve either intentional suicide or alcohol consumption. CNS depressants are also known to worsen symptoms of depression and substance use disorders involving alcohol and other depressants are closely tied to depressive disorders.
When Ambien and other CNS depressing sleep aids are abused, they can cause some of the same intoxicating effects as alcohol. You may feel relaxed to the point of euphoria and a release of inhibitions. Because of this, sleep-aids are sometimes taken in recreational settings where alcohol may also be present. To heighten the high, people may be inclined to drink alcohol at the same time.
In other cases, anxiety or insomnia may be so severe, people attempt to increase the effects of the sleep-aid with the help of alcohol.
Ambien is often said to be among the safer sleep aids, but when it is abused or mixed with other substances, it can be incredibly dangerous.
Plus, self-medicating with alcohol may lead to dangerous adverse reactions, addiction, and the eventual worsening of symptoms.
Polydrug use refers to people who abuse or use multiple types of drugs concurrently. This can sometimes lead to substance abuse disorders (SUD) that involve multiple substances instead of just one. It’s common among people who struggle with substance use disorders to have had experiences with more than one substance. In party settings where drugs are involved, it’s likely that more than one substance will be available. However, SUDs involving multiple drugs can complicate treatment.
Alcohol and Ambien are both GABAergic substances, which means that they both work on the GABA receptors in the brain. However, they have some distinct side effects that make it clear that they are two different substances. People recovering from Ambien dependency may have a higher degree of sleeplessness and insomnia as a withdrawal side effect. However, both substances share very similar withdrawal symptoms and abuse of both can lead to more intense withdrawal.
If you stop using benzodiazepines and alcohol suddenly, you are more likely to experience severe symptoms of withdrawal, including:
Because CNS depressant withdrawal symptoms can be fatal without the proper medical treatment, it’s important that treatment for alcohol and Ambien addiction to start with medical detox.
In medical detox, you will receive 24 hours of care from medical professionals every day. Detoxification is the highest level of care in addiction treatment and involves medically managed services and constant supervision.
Through medical interventions, your safety will be ensured and clinicians will work to keep you as comfortable as possible as you go through withdrawal symptoms. Medical detox can also help by addressing issues related to other pressing medical or psychological needs, whether they are directly related to your addiction or not.
After detoxification, clinicians will help connect you to your ideal next level of care. In cases involving CNS depressants, the next step is often inpatient services. It involves 24 medical monitoring to make sure that you are safe from any lingering post-acute withdrawal symptoms.
Dependence is a condition that affects the chemical messaging symptom in your brain and it can usually be addressed by detox.
Addiction, on the other hand, affects the reward and learning centers of the brain and represents a much deeper problem. Overcoming addiction means long-term treatment and evidence-based therapies that address multiple issues.
Alcohol and Ambien abuse is a dangerous form of substance use disorder. If it turns into an addiction, it can get out of control quickly. Addiction is a chronic disease that can cause long-lasting consequences. However, there are help and treatment available for addiction and alcoholism. Addiction is a serious disease that is difficult to overcome, but with help and the right resources, you may be able to live a life free from active addiction.
American Journal of Therapeutics. (2011, July). Zolpidem Misuse with Other Medications or Alcohol: American Journal of Therapeutics. Retrieved from https://journals.lww.com/americantherapeutics/Abstract/2011/07000/Zolpidem_Misuse_With_Other_Medications_or_Alcohol.7.aspx
CDC. (2017, May 02). Sleep and Sleep Disorders. Retrieved from https://www.cdc.gov/sleep/data_statistics.html
Glock, S. B. (1999, October 01). Acute Zolpidem Overdose-Report of Two Cases * | Journal of Analytical Toxicology | Oxford Academic. Retrieved from https://academic.oup.com/jat/article/23/6/559/863571
Hoque, R., & Chesson, A. L. (2009, October 15). Zolpidem-Induced Sleepwalking, Sleep Related Eating Disorder, and Sleep-Driving. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762721/
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Sleep, Sleepiness, and Alcohol Use. Retrieved from https://pubs.niaaa.nih.gov/publications/arh25-2/101-109.htm