I have been on Ambien for a while. But it quit working and I have been without sleep for 4 days. What can I do now that my sleep medication no longer works?
Doctors Answers (5)
Depends on the root cause. If you have not been evaluated by a sleep physician I would strongly suggest you find someone in your area and make an appointment as soon as possible. There are many reasons for insomnia. Addressing the root cause is important.
Unfortunately, there isn't an easy answer. Finding the reason why you can't fall asleep should be the first step. People should be able to fall asleep as its a natural process for the body to recuperate. Its unnatural that the body can't perform one of its basic survival needs. Reasons why someone can't fall asleep may include, but are not limited to chronic pain, anxiety, stress, sleep breathing disorders, too much visual stimuli before bed, and disturbing noise and lights. Finding the cause is sometimes difficult because it may be something that has been a problem for so long, people aren't aware of it. For instance, a pain in the the foot, jaw, back, etc causes pain that a person has learned to live with, but it can increased cortisol levels due to the pain, thus preventing someone from falling asleep.
Unfortunately you may now have 2 problems. You have insomnia as well as a hypnotic dependent sleep disorder. Drugs like Ambien were never designed for long term use and can be dangerous increasing mortality as well as inducing dependence. You should see your doctor and get on a schedule to wean off the medicine as well as using other methods like taking Melatonin in combination with a sedating antidepressant like Mirtazepine. You should also consult a sleep specialist to use Cognitive Behavioural therapies like sleep restriction and stimulus control and cognitive behavioral therapy.
It is very important to speak with your primary care doctor or sleep specialist if your sleep medication stops working. There are a variety of reasons that this can occur, so it is important to get to the bottom of the problem. It is generally inadvisable to continue taking a sleep medication that is "not working," so it is important to assess the situation and determine the appropriate treatment approach.
Medications for sleep (hypnotics) occasionally fail to be effective. There are numerous possible causes including tolerance (your system has become tolerant of a certain dose or the drug altogether), other new medications which are competing with Ambien, an underlying medical disorder, etc. If a small increase in the dose does not correct the problem, then switching to another FDA approved hypnotic should be considered. Ambien may work again in the future. Many patients alternate hypnotics every few nights. Finally, as with all medications taken on an "as needed" basis should be tried at the lowest dose possible or even skipped on occasion. Cognitive Behavioral Therapy should be explored.