Ambien - is it reprogramming your mind while you sleep?

Jun 27 2013 - 4:05pm
Brain morguefile.com

Ambien is one of those drugs that everyone knows by name; in that since it is like valium or Viagra. When the stress of life makes sleep a bit elusive, people have no problem calling their physician and asking for Ambien by name. They view Ambien about the same as M&Ms or a Tic Tac – in other words, harmless. In terms of popularity, Ambien, depending on year, is usually around number 15 on the list of most prescribed drugs in the U.S.

Ambien a.k.a. Zolpiden, which doesn’t roll off the tongue nearly as easily, is a short-acting hypnotic (15-20 minute onset, ½ life of 2-3 hours); and while it is a hypnotic, it is not in the benzodiazepine category. However, it’s mechanism of inducing sleep is very similar, that is, it potentiates GABA, which is an inhibitory neurotransmitter. By binding to GABA receptors in the central nervous system, Ambien helps set the conditions for easing quickly into sleep. Generally speaking, Ambien, and other GABA mimetic drugs, do not do as well at maintaining your sleep once it has started.

So what’s the problem?

Hallucinations are a side effect of Ambien use, although, not a very common one. However, this side effect tells us that Ambien is hard at work in the deepest, darkest corners of our mind and is doing a bit more than just making us fell a little sleepy. Regrettably, it is very, very, hard to monkey around with neurotransmitters in the brain and produce highly targeted and very selective outcomes. The receptors for a particular neurotransmitter tend to be scatter widely throughout the brain. As a result, drugs acting on the central nervous system can have some very peculiar side effects.

In a very interesting study published June 14, 2013 in the Journal of Cognitive Neuroscience, Investigators at the University of California, Riverside found that memory accuracy was actually improved after taking Ambien, not reduced. They attributed this to an increase in something called “memory spindle” activity. This is a type of brain activity that helps you convert short-term memory into long term memory. It is perhaps not widely known, but this is one of the important functions of sleep. Poor sleep interferes with this process; which is why teachers always tell students that cramming the night before a test is truly a wasted effort and a waste of time.

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What could be better than a sleeping pill that, instead of giving you amnesia (as some do), gives you better memory of the preceding day’s events? Well, here’s the problem, not all your memories are good or positive. The researchers found that Ambien did a very good job at helping your remember negative and high-arousal stimuli but not positive and low-arousal stimuli. Let me digress here to explain the use of the word arousal. For good or not, the word arousal is inextricably linked to the word sexual. In the context of this research they do not mean sexual arousal or erotic stimuli.

Study participants were asked to look at 5 categories of pictures “(1) positive, low arousal, including an image of a kitten; (2) positive, high arousal, such as a picture of a roller coaster; (3) negative, low arousal, for instance, an image of people gathered around a grave site; (4) negative, high arousal, such as a picture of a snake about to attack; and (5) neutral images, such as a tree.” Participants were then given an Ambien, a stimulant, or a placebo and asked to take a nap. After a period of sleep, the participants were tested to see which, and how many, images they remembered.

The results: researchers reported that memory accuracy was significantly better in Ambien-enriched sleep (P = .005) vs. placebo. “The significant difference in memory accuracy with Ambien existed for both negative and high-arousal stimuli but not for positive or low-arousal stimuli.” “I was surprised by the specificity of the results, that the emotional memory improvement was specifically for negative and high-arousal memories," Dr. Mednick, one of the study co-authors, said in a statement.

The moral of this tale of pharmaceutically induced sleep is:

If your sleep difficulties stem from negative or unpleasant experiences, or if you suffer from post traumatic stress syndrome, then Ambien may not be a good choice. The same would also be true for Valium and other benzodiazepines, which work the same as Ambien and can cause similar problems. If you use Ambien, it might be a good idea to monitor your mood. It is possible that having your brain continuously selecting the more negative aspects of yesterday for transfer to your long-term memory, could start to impact your outlook on life.

No doubt these provocative results will trigger much needed research into sleeping medications and memory, so stay tuned. Until then, I glass of warm milk actually does work pretty good.

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