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Ambien and the Other ZDrugs

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Hi Sleepers!

Everybody welcome back to the channel let’s talk about sleep today i wanted to talk about a an important topic out there the so called z drug so what does that mean everybody’s heard of ambien most people heard a lunesta some people heard of sanada he’s under the category of what’s known as z drugs because the generic man has a z in it somewhere so zolpidem which is

Ambien zallah plan which is sanada and he’s zopiclone which is lunesta now these medications are on a category together because they don’t they have certain properties that are the same across all three that are similar to what what are known as benzodiazepine medication so what are those those are the ones everybody’s heard of so xanax klonopin excuse me ativan

These are these are medications which are technically anti-anxiety medications that we sometimes use in the sleep world the zeen medications again that’s ambien lunesta and sanada there have some properties or the same as that benzodiazepines but are a little bit different so the way we think of ambien sanada and lunesta is the following so ambien is considered to

Be kind of the standard insomnia medication you take it around bedtime it helps you fall asleep may help you to stay asleep lunesta is a little bit longer acting than that and then sanada is the short acting one so sanada is used for either getting to sleep initially or in the middle of the night if you have at least four hours and bed you take that to help you get

Back to sleep lunesta typically is given before bedtime to help people more so stay asleep and then ambient can be used for either that is also the delayed release ambient version or the sustained released the ambien cr so all these medications do they’re basically there they’re essentially just just sleep aids they don’t really help with anxiety they don’t help

With any kind of other underlying issue and they really only used there should be you is really just as an as-needed basis right but what i see my practice a lot is people use these medications every single night so what i tell people is this when when ambien is prescribed willin ss prescribed dose not as prescribed my question is always is there something else

That’s that’s being missed right so let’s say somebody wakes up frequently throughout the night and you know the well-meaning who ever prescribes them lunesta to try keep them asleep well that’s good i mean that can help but my question is always well why why is this person waking up you know are we missing obstructive sleep apnea are we missing leg kicks or body

Movements throughout the night or a missing depression right that’s causing somebody to wake up because the medication like these c drugs is not going to help with that it may help with the symptoms but it’s not gonna help the underlying problem so when somebody comes up to see me and they’re on these medications particularly for not working i will say or i like

Let’s try to evaluate this so i tend to stay away from these medications unless somebody has tried other things and failed right the reason being is because these medications and the medical literature have been shown to have increased risk for dementia for memory problems with even death now i don’t necessarily believe those that data and i’ll tell you why these

Are usually epidemiologic studies which basically means that they take thousands of thousands and thousands of people and they kind of see what happens right so so in the make it then the studies that have been done it’s been shown that okay if you take this medication then you’re at risk for this but it’s not necessarily i took it and then this is what happened

It’s i was prescribed this medication so the person may not even have taken it really may take one dose and what i was tell people especially in the dementia realm is you know one of the first symptoms of somebody getting dementia is they have very bad sleep problems now i’m not saying anybody with insomnia is a risk for dementia i’m not saying that but what i am

Saying though is is what can happen in a data study for example would be lets say there’s a eighty year old person who is in the beginning stages of developing dementia and the primary care that geriatrician prescribes him ambien it’s not that the ambient cause that it said the ambien was used to try to help some of the symptoms not that the ins the ambient cause the

Dementia of that make sense but that’s not really why i try to avoid these medications as i said these medications really are the kind band-aids so let’s say say somebody does have depression prescribing them ambien or a lunesta is not really going to help that it’s it’s gonna you know maybe just knock them out but it’s not really gonna get to the root of the problem

I would rather try something or prescribe something that may help with some of those other issues for example i like tries it on graz oh do any this is a medication which is in the psychiatric problem and antidepressant technically which is used by psychiatrists at very very high doses for things like bipolar depression and and other things we use it in the sleep

World at a low dose because it does kind of help calm the mind down and it induces sleep and it’s not addictive so that’s that’s something which i tend to gravitate towards doxepin same kind of same way but the dizzy drugs while they’re not physically addictive right so the benzodiazepine medications those annexes the klonopins the ativans these can be physically

Addictive where what i mean by that is you take them frequently and then you stop you may go into withdrawal right ambien lunesta sanada they’re not gonna cause withdrawal now they may if somebody thinks them every single night and then stops think it can be a hell of a night or you know several hell over several nights with really bad rebound insomnia but they’re not

Gonna go into withdrawal okay so they’re not addictive in that in that sense but they are addictive psychologically right so i have many patients who have been on ambien for 10 10 plus years and i say look let’s try to come off it because there’s better things out there and i don’t think it’s it’s helping enough and they have a hell of a time doing it fortunately

What we’ll try to do in that case is is supplement with something else yeah so these medications like i said i’m not i’m not big a fan of but they they are out there and they can be used in certain circumstances so how would i use them all right let’s say somebody is let’s say somebody was dying with sleep apnea right and they’re very hesitant about using the cpap

Machine which is understandable what i may do in the beginning is a very very short course of a couple weeks to say all right look here let’s try ambien while you get used to the cpap machine just to kind of get you over that hump to show yourself that you can do it or conversely let’s say somebody tried every other medication under the sun and ambien is the only

Thing that works for them what i may say is all right look we’ve ruled out all this stuff you know ambien really does work for you it’s better for you to have some sleep even if it’s on ambien than no sleep at all this is my just personal personal opinion other physicians may have their own their own you know ways of doing it but that’s kind of the way the way i

Think of it so that’s a story again the z drugs each opel clone which is lunesta zolpidem which is ambien and as ala plan which is sanada so that’s kind of the long and short of it you know these are as i said medications that are very very common and are out there you know it’s they do work in certain cases but really the question is as i always say is you know

What are we missing all right so uh that’s the end of this video thank you for watching if you have questions please leave them in the comments section i will answer all them i please like this video if you enjoyed it please subscribe to the channel my book let’s talk about sleep is available on amazon in may of 2019 the paperback version will be available so you

Can look for it then as well and until then sleep well sleepers and i will talk to you soon

Transcribed from video
Ambien and the Other "Z"Drugs By Let’s Talk About Sleep