Dosage and administration

Ambien puts you to sleep more rapidly and keeps you asleep longer than the older benzodiazepines drugs. As with all other prescription medications, you should follow the directions given by your doctor or as set out in the instructions supplied with the medication. If there is anything that you do not understand, you should ask your doctor or pharmacist to explain. It is supplied in tablet form as doses of 5mg and 10mg, which should be taken without food just before your normal bedtime. If you take the pill on a full stomach, it will take longer to produce its effect.

Do not be taken by surprise. Ambien is designed to induce a rapid onset of sleep. You should be ready to go to bed immediately after swallowing the pill, and be prepared to stay in bed for at least seven hours. You are warned that if you get up too soon, you may experience memory problems. For Ambien CR, you must remember to take them whole. Do not crush or chew them.

The maximum safe dose in any given day is 10mg for an adult. If you forget to take a dose, never double the next dose to "catch up". It is dangerous to exceed this dose because it may lead to dependence. If you do take more than you should over a longer period of time than recommended, you should consult your doctor before stopping. There may be withdrawal symptoms to manage after you stop in these circumstances.

Ambien is eliminated from the body by the liver. If you have an insufficient liver function, e.g. because of hepatitis, you should only take the smaller dose. Similarly, older people take longer to eliminate Ambien from their bodies so, if you are aged over fifty-five years, you should only take the smaller doses.

The general rule for prescribing Ambien is that it should not be taken for more than ten days in any given run of treatment. Alternatively, the pills are taken intermittently as and when needed. The aim of these limitations is to reduce the risks of addiction or dependence. There is also a problem that as the body becomes more tolerant of the drug, Ambien may begin to lose some of its effectiveness. In some people, there is a further problem of rebound insomnia when they stop taking the drug, i.e. you may not be able to get to sleep the first night after you stop the treatment. Once you start a run of treatment, you should see improvement over the ten-day period. You should be monitoring your sleep patterns. Keeping a diary may be a useful way of keeping track of trends. If your sleep problems do not show improvement or get worse at any time during your treatment, consult your doctor immediately.

As to storage, you should keep the tablets at room temperature in an airtight container. Avoid excess heat and moisture (so do not keep Ambien in the bathroom) and keep it out of the reach of children. As soon as you decide to stop taking Ambien, you should throw away any unused tablets. Similarly, you should dispose of any tablets that are out-of-date. If you are worried about safety in disposing of any drugs, ask your pharmacist.

Warnings

	You should not take Ambien when you have consumed alcohol or when you have a history of alcohol or recreational drug taking. Alcohol has an additive effect when mixed with Ambien. Further, if you are already addicted to alcohol or recreational drugs, you may also become dependent on Ambien.
	Ambien reduces the rate at which you breathe. Thus, you should not take Ambien when you have asthma, sleep apnoea (a condition where you may briefly stop breathing while asleep) or one of the other respiratory diseases.
	Do not take Ambien if you have liver problems.
	Do not take Ambien if you have myasthenia gravis (a condition where your muscles tire easily and become weak).
	If you are pregnant, Ambien can sedate your baby in the later stages before birth. The baby may also be born dependent on Ambien. You should also not breast-feed if Ambien is in your body.
	Because of the additive effects, you should not mix Ambien with other sedative and tranquillising drugs.
	In some people, Ambien can cause a change to your mood. The research is not clear on the cause and effect involved. Because one of the causes of insomnia is depression, it is not easy to say what side-effects may be caused by Ambien and what results from your other medical conditions. But, if you find your behaviour changing, perhaps you are becoming a little more aggressive or hallucinating, have difficulty in concentrating or memory problems, you must tell your doctor immediately. You should also tell your family and friends to look out for these changes in you. They may be the best judges of when any changes are significant and can call the doctor on your behalf.

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.