How does Ambien work?

Ambien is an imidazopyridine derivative available on prescription in most countries, and it works as a nonbenzodiazepine hypnotic to treat insomnia and some other conditions. When taken, it acts as a rapid-onset, short-duration drug to interact at the benzodiazepine recognition site in the brain. The active component of the drug works in combination with Gamma-Aminobutyric Acid (GABA) — a natural brain chemical that serves as a neurotransmitter to communicate signals, and amplify and modulate those signals between a cell and an adjacent neuron. The combination of Ambien and GABA works to reduce the general level of electrical activity in particular areas of the brain associated with sleep. Because brain activity drops, you are more likely to fall sleep.

As patented by the French manufacturer, Sanofi-Aventis, Ambien is chemically distinctive. It does not work in the same way as the older benzodiazepines drugs such as Valium and Halcion, which combat insomnia by inducing sedation. Although most drugs of this type do interact with GABA, clinical studies show Ambien targeting very specific areas of the brain unlike the other drugs that appear to have a non-selective effect. Ambien is also distinguishable from the benzodiazepines because:

• it does not act as a muscle relaxant;
• it does not have an anti-seizure effect;
• it does not disturb physiological sleep; and
• more significantly, because it is effective at dosages up to ten times lower. There are therefore fewer adverse side-effects because smaller dosages are needed for the same sleep-inducing effect.

When taken, Ambien usually produces sleep within about fifteen minutes and it has a short half-life of about two-and-a-half hours.

Ambien CR is a different version of Ambien used to reduce the effects of insomnia. It is supplied as a dual-layer tablet which allows it to work in two distinct ways:

• the surface layer dissolves quickly and usually brings on sleep within fifteen minutes; and
• the inner layer dissolves more slowly and allows you to stay asleep for a longer period of time.

Until you build up experience in using Ambien CR, you should spend at least seven hours either sleeping or resting before being active again. It can cause you to be very drowsy when you awake and you should not drive or operate any dangerous machinery until you are fully alert.

How does cognitive behavioural therapy help? One of the best alternatives to simple reliance on a drug like Ambien is cognitive behavioural therapy (CBT). CBT teaches you a new set of behaviours around the "activity" of sleep. You have to "relearn" the association between going to bed and falling sleep.

The habit of sleep Before you start taking Ambien or alongside a course of Ambien, you should change your habit patterns and practise relaxation techniques to help you get to sleep.