Snooze Alarm: The Pill That Drove Us to Sleep

By Hank Stuever
Washington Post Staff Writer
Saturday, May 6, 2006

Zolpidem tartrate, the sedative-hypnotic better known to wide-awake, stressed-out sheet kickers as Ambien, is an efficacious little helper if you ever thought you might go crazy from not sleeping. It's "Goodnight Moon" for grown-ups. You should take it only with some Charlie Rose. Now it's also become the new explanation for that which goes bump in the night: I took an Ambien, Americans are saying, and then I don't know exactly what happened.

In explaining his Ford Mustang's woozy middle-of-the-night encounter Thursday with a Capitol security barrier, Rep. Patrick Kennedy (D-R.I.) joined a growing list of people who have partly or entirely blamed the popular sleeping pill for things that have happened out of bed. At a news conference yesterday, he said he was going back to rehab to again seek help for addiction to painkillers. He said he doesn't remember what happened at all, and again mentioned "medications" that he had taken. In addition to Ambien, Kennedy, 38, said that he had taken Phenergan for stomach and intestinal problems.

Once again, the national medicine cabinet practically begs to be snooped through. Setting aside for the moment his addiction problems, Kennedy doesn't seem all that different from a lot of almost-40 Washington wonks and wonkettes you might know. You ask them, "What's really wrong?" and they say it's nothing, getting up, flicking on the bathroom light. It's his stomach, it's his head, it's the committee meeting tomorrow. You hear the rattling of pills in a plastic bottle, the faucet running, then it's nighty-night, or something close to it.

Commercials for an Ambien competitor, Lunesta, offer the curled-up solace of the magic green moth; another commercial has sleepless wretches lassoing the moon. Ambien, in proper dosage, is one thing. It won't send you to the Mayo Clinic, and it sure beats snarling at your co-workers the next day. But many people do ignore its warnings and take it with, say, a nice glass of Bordeaux. Then they call you and start talking; it makes them entirely too truthy. ("What was that about?" you ask them a day or two later. "What was what about?" they say, and then remember: "Oh, Ambien." Say no more.)

Before Ambien became popular more than a decade ago, Type-A people who didn't want to take up residence in the Valley of the Dolls had to mostly make do with over-the-counter sleep aids: Unisom and its ilk packed a slow-acting wallop, requiring a pot of coffee to undo the morning-after effects. Entertainment mogul David Geffen used to swear by Tylenol PM.

What Ambien blessedly did was knock you straight into lights-out within 20 minutes or so, before you could even finish reading a "Talk of the Town" short in the New Yorker. You'd wake almost exactly eight hours later, completely dreamless, magazine subscription cards plastered to your chest, and feeling fine, feeling very Snow White on a spring day.

After all these beautiful nights together, according to recent news reports, the Ambien zombies are arising against their will to gorge themselves at the fridge, or take the wheel, or do something illegal.

It wasn't me, officer; it was Ambien. Cops in Washington state tell the New York Times that an increasing number of middle-of-the-night car crashes are connected to the drug. An unnamed nurse in Denver was pulled over, in her nightie, and promptly urinated on the street; she had taken an Ambien before going to bed and claimed not to know how she got there or who drank the half-bottle of wine on her counter. Sean Joyce, a British man on a flight from Charlotte to London, was arrested last year because he belligerently ripped off his shirt and threatened suicide, the Times reported. Joyce received a reduced, five-day sentence because he'd had an Ambien and a couple of those airplane bottles of wine; he remembered none of it. Watchdog groups say the drug is overprescribed and too easy to get.

We are lagged-out, pajama-wearing drifters -- lost in the gap between slumber and wakey-wakey, even though Ambien's manufacturer, Sanofi-Aventis, implores users to follow the directions, as always: Take the drug only when you're on your way to (or already in) bed, and only when you have seven or eight uninterrupted hours to devote to sleep; don't take it with booze; make sure your doctor knows if you're taking anything else. Which is good advice, but is often met with "blah blah blah."

There are no rock songs about Ambien, and if there were, they would be really slow. (There could be poetry about it, perhaps, but who'd be awake to read it?) People won't share their Vicodin, but they'll let you have half an Ambien. People seem to take it not for a week to 10 days, as recommended, but for years on end. And let's not say much about sex and Ambien, since there isn't much sex and Ambien: I'll just lay here, you do your thing, and. . . . Zzzzzzzzzzzzz.

In March, after Ambien was mentioned as a possible cause of several sleepwalking (or sleepdriving) incidents -- and perhaps girding itself for the inevitable lawsuits from users who wound up becoming creatures of the night under its influence -- Sanofi-Aventis issued a firm statement:

"Recent anecdotal reports in the media have focused on rare occurrences of sleepwalking and sleep-related eating in patients who may also be taking Ambien. The safety profile of Ambien is well established and reported in the . . . prescribing information approved by the U.S. Food and Drug Administration. After recently conducting a thorough analysis, Sanofi-Aventis has not observed any significant change in that safety profile. . . . The information currently contained in the U.S. prescribing information remains accurate: somnambulism is a possible rare adverse event. . . ."

Go on, read the entire statement, everything about Ambien, dear Ambien. Sweet, inculpable Ambien. As indications and cautions and data scroll by, your lids get heavy, and the longer it goes on, the less you remember. We got almost 27 million prescriptions for the stuff last year. That explains a lot, and why Americans cannot be completely blamed for what happened. For any of it, whatever it was.

© 2006 The Washington Post Company