March 23, 2006:-   "Tomorrow will thank you."

That hopeful promise is the advertising slogan for a product we've heard a lot about lately: the sleep-aid Ambien.

Ambien had quite a wild ride in the media last week. Several reports on network television and in major newspapers made it clear that some Ambien users found tomorrow to be less than thankful. In fact, for a small percentage of Ambien users, tomorrow turned into a nightmare.

Strange behavior

According to reports in Reuters and the Washington Post:

Sanofi-Aventis (the maker of Ambien) claims the drug is responsible for "12 billion nights of patient use"
And some of those nights were quite eventful. The Washington Post article includes the account of a woman who took Ambien for six years (that's 2,190 nights of patient use) and blames the drug for an increase of 11 dress sizes due to midnight eating binges that she had no memory of in the morning. Empty ice cream cartons and potato chip bags tipped her off to her nocturnal habits.

Two Questions: Did it really take her six full years to make that connection? And can she really blame Ambien for all 11 of those dress size increases?

These questions may be answered when the size-12 woman and others have their day in court: A number of plaintiffs have filed a class-action lawsuit against Sanofi-Aventis, claiming that under the influence of Ambien they binged on snacks, drove cars (with sometimes disastrous results), and even shoplifted - all the while completely "asleep" and unaware of what they were doing.

Do they have a sound case? Maybe...maybe not. On the Ambien web site, a list of uncommon but potential side effects associated with Ambien use includes hallucinations and strange behavior. Yeah, I'd say sleep-shoplifting after sleep-driving to a store qualifies as fairly strange behavior.

Unfortunately, all this news may have prompted many Ambien users to abruptly stop taking the drug. Which is not a good idea. The Ambien site states: "Withdrawal symptoms may include unpleasant feelings. In more severe cases, abdominal and muscle cramps, vomiting, sweating, shakiness, and rarely, seizures may occur."

As Clint Eastwood might say to someone thinking about discontinuing Ambien use: "Are you feeling lucky?"

Sweet dreams

Chances are, those folks who fell under Ambien's strange behavior spell might have found a far more restful night's sleep if they'd only tried some non-pharmaceutical sleep-aids first. For starters, they could go to the Ambien web site where they'd find a list of seven tips for a better night's sleep. And the tips are actually pretty good.

For instance, regular exercise can have a profound effect on sleep patterns. Creating relaxing routines at bedtime and avoiding caffeine and spicy meals late in the day can also be helpful. But if these tips don't work, there are several supplements that might do the trick without the heavy side effects of drugs.

In previous e-Alerts I've told you about l-tryptophan, a natural sedative and sleep-inducing amino acid. The FDA banned l-tryptophan supplements in 1990, but this misguided ban was recently lifted. In addition to l-tryptophan, HSI Panelist Allan Spreen, M.D., has recommended three other sleep-inducing supplements: melatonin, valerian and kava.

Dr. Spreen: "If I really needed sleep (and couldn't get it) I'd never do any of the Rx drugs, period, but I would have no problem with proper use of any of those four (my favorite being l-tryptophan for younger ages, tryptophan or melatonin for the older folks)."

But could any of these natural sleep-inducers cause fogginess or impairment? Dr. Spreen says that the risk is FAR less among the four natural agents, especially l-tryptophan. "I've never seen a 'drug fog' with that, and that's even when many grams are required to get some sleep for a difficult subject. Enough kava might do it, but you'd have to be deliberately overdosing. Valerian seems to be the mildest of the bunch."

As for melatonin supplements, Dr. Spreen notes that a large dose might cause you to wake up feeling drowsy (a sign that you've taken too much). Dr. Spreen adds that he's more cautious with melatonin, which is a hormone. Our natural melatonin production decreases as we age, so Dr. Spreen doesn't recommend it for anyone under 40.

Dr. Spreen: "The cautious types talk about 1.5 mg at bedtime (never anytime but bedtime), for ages 40 to 50, then 3 milligrams for people over age 50. I subscribe to that. Those who take lots more I think are swimming in uncharted waters - nobody has any real data that it's bad (nor that it's not)."

If you're having trouble sleeping, talk to your doctor or a health care professional before using any of these sleep aids.

To Your Good Health, Jenny Thompson

Sources:

"To Sleep, Perchance to...Walk" Martin F. Downs, The Washington Post, 3/14/06, washingtonpost.com
 
"Bizarre Events Linked to Sleeping Pills in US" Reuters Health, 3/15/06, reutershealth.com

"Evaluation of Plasma Homocysteine and Risk of Age-Related Macular Degeneration" American Journal of Ophthalmology, Vol. 141, No. 1, January 2006, ncbi.nlm.nih.gov

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