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She is being given sleeping pills by her care giver and it is not helping her sleep and it seems to be making her more confused...

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I will restate what I said-I'm not saying anyone is addicted. I shared that I WAS with you, vegsister and Kristen and I did not have to do that. It was VERY PERSONAL INFORMATION. Best wishes to you both.
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Vegister: Very well stated. I would love to know if there is another potential intervention that you might take in that week before your period. I think it is really interesting that you can go off and on Ambien without rebound insomnia.
I wonder if you might get helped by taking a calcium/magnesium supplement proactively on about day 15. Have you tried the pill? Perhaps hormonal modulation might be your ticket.
However, one week of Ambien certainly isn't anything to be concerned about, given your ease of discontinuation. Best of luck!
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I agree Kristen3 except on one thing: zolpidem is not addictive for everyone.

I have not had to increase dose over time to experience results, which is among the definitions of an addictive substance. In fact, I have reduced the dose since I started taking it regularly. Recently, I stopped taking it altogether and found that on most nights except for the week or so before my period (I am a premenopausal woman) I sleep just fine. Even the first night off a stretch of needing it every night.

My point being that responses to psychoactive drugs are extremely individual and no one, doctor or layperson, should speak with authority on insomnia absent extensive personal experience and/or research on the subject. Blanket statements that throw all sufferers into the same "addicted" basket and make unwarranted judgements are no substitute for thoughtful understanding based on experience and knowledge. Drug labels reflect a lowest common denominator and are there for other reasons besides to protect the consumer.
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Llamalover: I clearly understand that antibiotics and insulin don't have the "addiction" warnings because they are not psychoactive drugs. My point is that drugs that fall into that category are stigmatized, as are the people who develop a dependency on them. Vegister and I are in agreement that "insomnia" should be a medically recognized condition as much as diabetes is. I personally despise Ambien because after two doses, it is almost impossible to fall asleep naturally again. I CLEARLY recognize that it causes dependency, but if that is the only thing that brings relief to someone, why should we hold them in question as to their "addiction?" We need to reframe our attitudes towards these substances because insomnia is, in some cases, a CHRONIC ailment. The person who has had a liver transplant taking anti-rejection drugs is just as legitimately dependent on that drug as an insomniac is on Ambien. Why talk about "crutches" and other means of eliminating dependency when insomnia is the main issue? You wouldn't try to "reform" a person dependent on anti-rejection drugs, would you? There is a component of blame here that further victimizes the insomniac because treatment involves psychoactive substances. I agree with you Llama that people are taking drugs that cause addiction. Point being is that we must stop judging them. If Vegister is not having the more dangerous side effects, why try to "reform" her? (or him) My sister was "addicted" to Ativan in the last years of her life. My mother was concerned that she was becoming dependent. I was aghast. Would you really expect someone with a terminal disease not to have anxiety?? Again, the drug gets stigmatized and the larger picture gets ignored.
It would be wonderful if everyone were able to achieve perfect inner balance through meditation and "mindfulness." I say, let people use whatever means they need to achieve a good night's sleep unless they become a danger to themselves or others.?
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I am not saying anyone is addicted. I am saying I was and it's EXTREMELY HARD TO STOP AN ADDICTIVE SUBSTANCE
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Kristen: No, insulation and antibiotics don't have a warning on the bottle/syringe as being addictive. I took Ambien-just one or two pills and my doc told me to stop the med. I am probably your best help b/c I used to be addicted to ephedrine. Any drug that you cannot do without is a habit that is indeed VERY HARD TO STOP! Go to Reform U
Reformers Unanimous.
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My point exactly Kristen3. I get a little testy when people tell me I am "addicted" like zolpidem is heroin because I have argued with so many doctors who don't know a thing about insomnia, who tried to convince me that I needed an antidepressant or needed more exercise or needed not to drink alcohol or caffeine or to eat meat or eat less sugar, when what I really needed was just. something. to help me. sleep.

I mentioned head injuries because I had a serious one as a child, and there is evidence that they can lead to chronic insomnia (not to mention early-onset Alzheimer's-like symptoms--ask a retired football player).

Incidentally, I slept well last night with no zolpidem. Last week, I went a week with almost no sleep trying not to take zolpidem. There is definitely a hormonal/cyclical component.

There is a long history to the classification of insomnia as only a secondary condition to depression or trauma or other disease, and not a condition in its own right. This is why doctors and laypeople are unwilling to accept that sometimes we just need to treat the insomnia and not try to blame the insomniac for not sleeping well. That classification is now changing. I'll recommend again the excellent book _Insomniac_ by Gayle Greene

I am sorry for your woes KM1027, I've had good results with zolpidem and noticed no difference between that and Ambien, but we all respond so differently to these things. I hope you find relief.
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Llamalover and vegister: Would you be talking about medication being a "crutch" if it was insulin or an antibiotic? Insomnia is a legitimate medical condition that needs legitimate treatment. Why are we as a society having judgments about sleeping meds? Just because a drug has psychoactive qualities, why do we refer to that classification of drug as a "crutch?"
Granted, I have had bouts of insomnia in my life for which I took sleeping medications. I am happy to report that I have moved through those periods. However, I wouldn't hesitate to take something if I were in a situation that was preventing me from sleeping. Implying that Vegister needs to get off the medications is basically telling that person that they are doing something wrong. If someone is functional on Ambien, and can afford it, I don't see why they need to be made to feel guilty for taking it. Personally, I cannot stand that drug. Restoril is a better drug in my opinion since it has a longer half-life and doesn't have any hangover effect. I like the comments regarding the lemon balm and Kefir as alternatives to medications.
My point is, we must try to have compassion for the journeys that others are taking regardless of their medication status.
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Vegsister: If you need it every night, then it is now your crutch. I would seriously suggest you, with your doc's help wean yourself off from it. I am not trying to be mean. I was addicted to ephedrine for years.
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There is a app for smart phones called GoodRX that allows you to type in a med and get a price from pharmacies in your area
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Vegsister: Re: Blood test for lack of serotonin produced in brain. I had the blood test at the Mayo Clinic many years ago. Can't even tell you what it was. Also, I am also on 10mg. of Lexapro along with the sleeping pills. At first it did improve my sleep, but no longer helps in that respect. I am not a big believer in herbal remedies. I know many are, but they have never worked for me and I am allergic to the pill form of melatonin.
Unfortunately, I have had to switch to the generic of both Lexapro ( esitalopram) and Ambien ( zolpidem) and no one can ever convince me they are the same. I am a mess on the Zolpidem. I have fallen several times getting up during the night on the Zolpidem. I had absolutely no side effects from brand name Ambien. I woke up bright and alive. Now I walk around till about 3 PM every day with brain fog and a headache. As for the Lexapro, the esitalopram does not cover my anxiety problems near as well as the brand Lexapro. I have had quite a few anxiety attacks on the generic and I am very anxious when I have to leave my house. I would give anything to go back on the brand names of these two, but the Ambien is $ 475 a month and the Lexapro is $ 375 a month. I can't afford that. Who can pay for these drugs?
Anybody know where to get the brand names cheaper. I have checked Costco, Target and CVS- all pretty much the same. I used to go to Walgreens, but they are the most expensive. My life has changed so much for the worse being on these generics. KM
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Hi. My mother has stroke-related dementia which causes her to have sleeping through the night problems even while she's on sleeping medications. I give her Lemon Balm and Relaxing Sleep, tinctures from Herb Pharm to relax her before giving her sleeping medications. Now she sleeps like a baby through the night. Whew! I actually remember reading Lemon Balm is used in Europe to treat agitation and restlessness in patients living with Alzheimer's. You can purchase these high quality tinctures from Whole Foods, Sprouts or Amazon. I personally purchase from Amazon since I rarely have time to shop in the store. Thank goodness for being a Prime Member - love the two-day shipping!
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vegsister, I agree with you 100% that there are definitely sleep disorders that need medical intervention. My husband had REM Sleep Behavior Disorder (RBD), and a drug controlled that for about 30 years. Hooray!

I also strongly believe that helping persons with dementia sleep through the night is a high-priority in their treatment plan.

I strongly caution against using OTC sleeping aids for persons with dementia without a doctor's supervision. Benadryl, for example, was definitely contraindicated for my husband's disease, and if I'd simply tried Do-It-Yourself advice I might have made matters worse.

Absolutely work toward improving a loved one's sleep. Just don't rely on trial-and-error without the advice and supervision of a knowledgeable doctor (a sleep specialist and/or a dementia specialist).
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Llamalover: It seems people have very individual reactions to Ambien. According to the sleep specialist I see, I am not alone in being able to take it long term with no diminution in benefits (which defies the definition of an addictive substance). And yes, I think every day about getting off it, and I attempt to do so regularly. Sometimes it works for a few weeks or even months.

But, I trust myself behind the wheel far more after I've had a few good nights' sleep on Ambien than after weeks of getting 1-2 hours a night without it.

Certain physical conditions--old age, head injuries, hormonal conditions like KM1027 mentions--make sleep very difficult and I am a firm believer that sometimes, just as diabetics need insulin, insomniacs need some kind of help.
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vegsister: Ooo, taking Ambien for 10 years? Have you thought of how you are going to get off this script? Someone lost their DL b/c of Ambien.
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Edahmen: I stand corrected on the Benadryl. To others on this thread Kristen, ppalmer, Salisbury-that's right-RX sleeping aides have addictive properties!
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Actually, KM1027, Jeanne says A LOT of doctors are opposed to sleeping pills. That is not the same as ALL doctors. And I'll bet that many of those who generally oppose sleeping pills would make an exception for cases like yours. I am so glad you finally found a solution that works for you!
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Wow, Kristen3!

That is a story to remember!!!!!!!!!!!

I cannot say enough about having medications fine-tuned.
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My mother has been on the drug Lunesta for the last three years or so. Starting in June, she sustained a total of 10 falls. She walked around in a stuporous fog all day. We finally discontinued the drug on August 16, and she is a new person. The crazy thing is, she has absolutely no memory of any fall, even though three of them landed her in the emergency room. She is taking a product called Melatonex and sleeps through the night except for one or two trips to the bathroom. Her gait is steady and she hasn't fallen since Aug 19 or so.
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My father was given sleeping pills when he broke his arm. They worked the opposite way. He was very agitated and couldn't sleep at all. I tossed 'em. There were difficult nights and I was super tired. Some nights I would sit next to him in bed so he could put his head in my lap. I kept reminding him if we kept on going forward, he would look back on this time as a victory lap. He did get well and I finally got some rest. Now he is in Stage 1 Alzheimer's with a new set of challenges. Tell her doctor so it is in her records and toss 'em. Ask your doctor if Benadryl would be OK. That worked better for Dad.
Hang in there.
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If you want to try natural remedies, read Donna Gates' "Body Ecology Diet" pg. 105, discussion of Kefir (a probiotic cultured milk product) B vitamins, D, K, tryptophan converted into seratonin, additional calcium, magnesium, and their calming effects, especially for sleeping through the night. if your mom (like mine) is a sweet-lover, you'll have to sweeten it with stevia herb and fruit, as it is sour like a drinkable yogurt.
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Restoring more normal sleep patterns is really important for the patient, and not just for the caregiver. So, trials of different meds are well worth the effort. OTC meds commonly have benadryl (diphendydramine) which often is intolerable for elderly persons and can worsen function and can contribute to agitation or sedation the next day. Paradoxical reactions (agitation rather than sedation) are not uncommon, and the meds build up with daily use even thought the half life is technically short. On the other hand, there is much to try in the prescription categories: certain antidepressants such as trazodone, some of the antipsychotics used for dementia, and certain other 'sleeping pills' may be the one which finally helps in your case. Some people even do well on an NSAID at bedtime. All of these are meds which your doctor should be regulating.
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I too have had insomnia most of my life and have taken Ambien most nights for the past 10 years. It is not an addiction; if it were I would sleep less well if I stopped taking Ambien one night than I do if I had never taken Ambien in the first place, and I would have to take a larger and larger dose over time. Neither is true.

KM1027, I am curious what blood test you got that showed you lack a hormone to sleep! I am certain that I have a similar situation. You found a great doctor who knew what to look for. Most doctors receive about an hour of training in insomnia in 4 years of medical school and don't have a clue about it. The book _Insomniac_ by Gayle Greene is instructive.

I've tried just about everything and here is what I have found:
Paxil is an antidepressant that is also soporific and may help with insomnia
Other tricyclic antidepressants may also calm anxiety and have an effect on sleep
Trazodone helped me sleep for a few nights, but made my nose so dry I got a sinus infection
Benadryl is helpful but should NOT be taken regularly by those over the age of 65 (or anyone, I believe, just to be safe) for reasons Edahmen stated
Ambien CR addresses the problem of waking up after 4 hours, as it releases the drug gradually over the night
Xanax addresses anxiety, and can put a sufferer to sleep
Gabapentin is used as a painkiller for arthritis, and as an anti-seizure medication, and can be great for insomnia
Valerian tea or capsules can be helpful
3 herb formulas in combination can be helpful: Gaia Sleep Formula, Seriphos, and Cortisol Management
I have more on these on my blog at peacefuldog.blogspot/2011/12/non-canine-sleep-aids-ncsas.html

Of course, consult your doctor about any of these. Good luck finding one who knows anything about insomnia. IMO, anyone who says any group of people should never take sleep meds has never lived with the life-destroying misery of chronic insomnia.
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Benedryl is a big no-no for dementia patients. It interferes with the aceticocholine (sp?) cycle somehow. However, since my husband frequently pops awake at 4 am (wide-awake Willie), I take the benedryl myself so I can at least get a few good hours in. So far I refuse to give him any sleep medication (melatonin has no effect). I would rather have him up than run around dopey and disoriented. Even last night he was totally out of it anyway around 3 am. It's a very hard time when he has a couple bad nights. But I did find he sleeps more the next couple of days. Sure wish I could find what triggers the early morning awakening.
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Unbelievable coincidence:

I had lunch with a friend today--79 years old.. Her daughter (40) has gotten three DUIs and has lost her drivers license for eight years! Now my poor friend and her husband have their daughter living with them, and they have to drive her back and forth to work and everywhere she goes.

Wait, wait, here is the punchline:

It wasn't alcohol. She got DUIs for driving under the influence of Ambien!!!!!!!!!!

Just heard that today. Honest.
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KM1027: I am very glad that #1 you are being helped by the Ambien and #2 you are aware of its addictive properties.
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Dear Jeanne Gibs, First of all, two of my husband's Alzheimer doctors told me that you should never give a Alzheimer patient sleeping pills. It interferes with their very already deteriorating brain.
But, Jeanne says doctors say no one should take sleeping pills. I am75 and here to tell you I have taken sleeping pills ( Ambien) every single night for 25 years. From childhood on, I was never able to sleep, had to be taken home from camp with exhaustion, ruined vacations, finally in my 30's serious fibromyalgia - for 3 years, so bad I lost 60 lbs and was in a wheel chair for 2 years till finally a doctor at the Mayo Clinic bothered to take some samples of blood and found out that I did not secrete the necessary hormones to sleep. They could not be taken by pill or injection. I tried melatonin and was allergic to it. The doctor there told me that from 25 years of no sleep or at best 2-3 hours a night, I had worn by body down so badly that I got fibromyalgia. Apparently during sleep the muscles secrete toxins and rests so they are restored for the next day. So, I didn't have a choice. I finally am sleeping 7 hours a night- no I never wake on Ambien after a few hours, nor have I ever gotten up and eaten anything or done anything in my sleep. Thank God for Ambien. I have no side effects and if I didn't take this lifesaver, I would most likely be dead by now. My doctor at the Mayo Clinic said it is far better to be addicted to sleeping pills than to burn your body into the ground and die. I never take more than 5 mg. I am a very healthy person now and so apparently at age 75, the Ambien has no bad effects on my body. KM
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Start with the "lesser of the two evils"-OTC Benadryl.
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All I have to say is that medication works differently with people. What works for one, will not work for the other...try something for 3 or 4 days...and see if it's working, it not...try something else. gooood luck with that...nothing worse than not sleeping!
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No meds that affect the brain should be given without a doctor's knowledge and review of all other meds! Listen to others. Get a referral to a good geriatric psychiatrist. These doctors are not just for 'crazy people'....they specialize in the dementias and Alzheimers and they know which psych meds work well on the brain to calm anxiety, agitation, wandering and inability to sleep, hallucinations and all the rest of the things that come with the brain not sending signals back and forth correctly. It made a world of difference for my Dad to become a patient at a good office with great staff. In fact, I now believe that any good memory care or dementia facility should have an affiliation with a Geriatric-Psych office that will do 'home' visits to their facility. My Dad was on trazadone, respiradol, and a couple others at various times. He also was on an antidepressant drug that was known to increase appetite when he started losing weight. It's amazing all the things that happen to the body when the brain is not able to send the right signals at the right time, or in the right order!!
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