ARTICLE OVERVIEW: Ambien (zolpidem) is a hypnotic non-benzodiazepine, is very effective and widely prescribed in clinical practice for the treatment of insomnia and is believed to have few adverse effects. However, the adverse effects induced by zolpidem include short and long term symptoms. In this article, we list dangers and review the signs of a problem.
TABLE OF CONTENTS:
- What Is Ambien?
- How It Works
- Short-Term Effects
- Long-Term Effects
- Side Effects
- Signs of a Problem
- Overdose Signs
- Your Questions
What Is Ambien?
Ambien is the brand name for the medicine called “zolpidem”, which depresses the central nervous system. It is best prescribed for a period of a couple weeks or less to manage seizures, anxiety, or sleep disorders. It is a sedative so strong that it is dangerous to try to drive or perform physically demanding activities while in Ambien.
The amount of Ambien that you can take immediately is limited to 10 mg of zolpidem at night, before going to sleep. In most cases, sleep medicines should only be used for short periods of time, such as 1 or 2 days, and for no longer than 1 or 2 weeks. Doctors usually stop the medication after 30 days if you do not see a reduction in symptoms.
Zolpidem is available as an oral tablet (Ambien and generics), an extended-release tablet (Ambien CR and generics), a sublingual (under-the-tongue) tablet (Edluar), and an oral spray (Zolpimist). Is also available under the brand name Intermezzo, a lower dose sublingual tablet that is approved for use as needed for the treatment of insomnia when a middle-of-the-night awakening is followed by difficulty returning to sleep.
How Ambien Works
Ambien is a central nervous system depressant. This means that it slows brain activity. Most central nervous system depressants affect the brain in similar ways: they increase the activity of gamma-aminobutyric acid (GABA), a chemical that occurs naturally in the brain and sends messages between cells through neurotransmitters. GABA works by slowing brain activity. Although different types of CNS depressants work in unique ways, they all increase the activity of GABA, which produces a numbing or calming effect.
Ambien works incredibly fast in the body. It reaches the maximum concentrations in blood in 30 minutes after being ingested. It is important to take Ambien immediately before going to sleep, because of the rapidity with which its effects occur.
Depending on the time of night and the dose of Ambien that is being taken, the effects of the medication may persist until the next day. Some people claim that these effects they feel resemble a hangover from a night of heavy drinking.
The short-term effects that can be felt the next day are:
- Gastrointestinal disorders such as nausea.
- Memory loss.
- Persistent drowsiness.
In addition, there are numerous reports of sleepwalking and a strange phenomenon known as nocturnal feeding syndrome (or sleep) that can occur, especially in the context of multiple doses.
Addiction occurs when a person compulsively seeks out Ambien and uses it despite negative consequences.
The FDA-approved Ambien drug label warns doctors that they need to evaluate for co-morbid diagnosis and reevaluate if insomnia persists after 7 to 10 days of use. If taken for longer than this period, Ambien can provoke insomnia that is actually worse than the insomnia the drug was intended to treat. 
Furthermore, using sleep hypnotics such as Ambien for more than 4 weeks can lead to damaged sleep staging and abuse of it. Abuse can then lead to addiction. While this Medline Plus article on sleeping medicines claim that Ambien is not addictive, we’ve researched and found that possible long-term effects of Ambien include:
As with any other mind-altering drug, the potential for dependence on Ambien is a risk. Users who enjoy the effects of Ambien may start to use the medication while staying awake to experience the high associated with it. Because stopping Ambien can lead to returning sleep difficulty, a user may psychologically depend on it to use for longer than indicated.
However, physical dependence is different from addiction. Addiction occurs when a person compulsively seeks out Ambien and uses it despite negative consequences.
Abuse of Ambien may result in tolerance to its effects, which means that the person needs higher doses of zolpidem to reach the effects that they want, this happens because the body gets used to the presence of the drug.
Finally, Ambien is a hypnotic drug that acts on the central nervous system and slow the brain’s activity. This is why it is important to seek medical help when you stop taking Ambien. Activity in the brain can rebound and race out of control to the point that seizures can occur.
Other long-term effects include:
- Abdominal pain.
- Dry mouth.
- Loss of appetite.
- Loss of energy.
- Loss of memory.
- Mood swings.
- Muscle aches.
- Problems with coordination.
Ambien also depresses the respiratory system and if the underlying cause of insomnia is sleep apnea, this can reduce the drive to breathe.
The main side effects of taking Ambien are:
- Drunken behavior without odor of alcohol.
- Hangover feeling or daytime sleepiness.
- Impaired memory of events.
- Slurred speech.
Ambien is a medication that is prescribed for use as needed when a person is having difficulty sleeping, but it is not intended for everyday use. Many people who become dependent on Ambien and then stop taking the drug will experience withdrawal symptoms, including increased insomnia, anxiety, and in rare cases, seizures.
Central nervous system depressants should not be combined with any medication or substance that causes drowsiness, including prescription pain meds, cold and allergy medications, or alcohol. If combined, they can slow both the heart and respiration, which can lead to death. The FDA issued a serious warning in 2016 about mixing drugs with Ambien. Further, the Drug Abuse Warning Network reported a 220% increase in adverse reactions from zolpidem between 2005-2010. 
Zolpidem Related Emergency Department Visits Involving Adverse Reactions: 2005 to 2010 
Another risk of using too much Ambien is addiction. Some people enjoy the sedative-hypnotic effects of Ambien and may use the drug to elicit specific side effects. In fact, research has shown that Ambien use and abuse are on the rise in the United States and is more common in people who have a history of abusing other drugs, especially alcohol. One of the most common risks of Ambien is the combination with other drugs, also known as polysubstance use. Polysubstance use occurs when a person consumes more than one drug or alcohol at the same time.
Signs of a Problem
It is important to recognize the signs of Ambien abuse as early as possible to prevent an addiction from developing. The following are a list of adverse effects that require medical attention:
- A feeling of being drugged.
- Blurry vision.
- Hallucinations (seeing things or hearing voices that do not exist).
- Joint pain, especially in the neck or back.
- Lack of balance.
- Muscle aches or severe cramps.
- Nausea or vomiting.
- Pain, burning, or numbness in the arms, hands, legs, or feet.
- Ringing or pain in the ears.
- Sleepwalking or doing other behaviors while asleep or not fully awake (including driving).
- Stomach pain.
- Uncontrollable tremors or shaking.
- Unsteady gait or difficulty walking.
The bottom line is that Ambien may not be a safe drug, especially for management of chronic sleeping problems. Instead, the NCCIH, the National Center for Complementary and Integrative Health reports that relaxation techniques and melatonin supplement may be more helpful in the long-term.  Other treatments for sleeping problems outlined by the American Academy of Sleep Medicine’s Sleep Education therapies include :
- Bright Light Therapy
- Cognitive Behavioral Therapy
- Oral appliances, especially for sleep apnea
Someone who experiences significantly debilitating symptoms on a low Ambien dose may be more likely to experience even more severe effects in the event of an overdose. When a person overdoses on Ambien s/he may experience:
- Slowed breathing.
- Slowed heartbeat.
- Severe drowsiness.
- Loss of consciousness.
If you or someone you care about has experienced an Ambien overdose, contact emergency medical help immediately. An Ambien overdose can be lethal, so it is important to seek medical care as soon as possible to avoid long-term damage or death.
If you think that you or a loved one might have an Ambien addiction problem, you are not alone. If you are ready to learn more about signs of prescription pill addiction, leave us a question, comment or e-mail. We try to respond to all legitimate questions with personal and prompt replies.
Reference Sources:  FDA: Ambien Label
 FDA: FDA Warns About Serious Risks And Death When Combining Opioid Pain Or Cough Medicines With Benzodiazepines; Requires Its Strongest Warning
 SAMHSA: Emergency Department Visits For Adverse Reactions Involving The Insomnia Medication Zolpidem
 NIH: Sleep Disorders: In Depth
 AASM: Treatment And Therapy
NCBI: Adverse Reactions To Zolpidem: Case Reports And A Review Of The Literature
NCBI: Spontaneous Adverse Event Reports Associated With Zolpidem In The United States 2003–2012
NCBI: Zolpidem Intoxication Mimicking Narcotic Overdose: Response To Flumazenil
All of the information on this page has been reviewed and verified by a licensed medical professional.