Sleep Disorders

14 January 2011

Side effects of common sleep drug

The popular sleep drug Ambien can leave even the healthiest older people groggy and prone to stumbling, falling and confusion when they wake up.


The popular sleep drug Ambien (known in South Africa as zolpiden) can leave even the healthiest older people groggy and prone to stumbling, falling and confusion when they wake up, U.S. researchers found in a small study.

The drug, appears to act broadly in the brain and has a numbing effect for at least half an hour after waking, the researchers reported online in the Journal of the American Geriatric Society.

People should not avoid taking it but should be aware of the drug's effects, advised Dr Kenneth Wright Jr. of the University of Colorado at Boulder and colleagues.

"If you have an individual who, even when they take their sleep medications, they wake up in the middle of the night to go to the bathroom, they need to be aware that they are at greater risk of falling," Dr Wright said.

If a couple is travelling together, he added, perhaps both should avoid taking such a drug at the same time.

Development of safer meds

"What this also calls for is the development of new sleep medications that are effective but are safer," Dr Wright said.

Dr Wright's team tested 25 healthy adults by having them walk on a beam laid on the floor to test balance, and asking questions such as simple math problems to test thinking.

All had perfect balance and clear thinking when they were awakened after taking a placebo. But 7 of the 12 volunteers over the age of 60 stumbled off the beam when awakened after taking zolpidem, Dr Wright said.

"They are walking more slowly after they have taken zolpidem and they are more unstable," he said.

"You are much groggier, much more impaired more than twice as bad. You are slower and you can't think as clearly."

The effects were less pronounced in the adults under 60, but 3 of the 13 younger volunteers were also affected by zolpidem, Dr Wright's team found.

Widely popular drug

The drug is extremely popular, 7 billion doses of zolpidem have been prescribed worldwide, said Dr Wright.

Many sleep medications act on GABA, which affects sleep but also coordination and cognition, he said.

Safer sleep medications would target the regions specifically involved with sleep, Dr Wright said. The problem is that researchers do not fully understand where all these are and precisely how they work.

"These are temporary effects," he stressed. People are sometimes equally groggy after a sleepless night, so it would be important to continue taking the medications if prescribed.

(Reuters Health, Maggie Fox, January 2011)

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Dr Alison Bentley is a general practitioner who has consulted in sleep medicine and sleep disorders, in both adults and children of all ages, for almost 30 years. She also researches and publishes on a number of sleep-related topics both in formal research journals and lay publications including as editor of Sleep Matters, an educational newsletter on sleep disorders for doctors.

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