Harvard Health Letter

Ask the doctor: Is it okay to keep on taking Ambien for my sleeping problems?

Q. I am 70, have had sleep problems, and have started to take Ambien every night. It seems to be working very well. Is it okay if I keep on taking it?

A. When Ambien (the generic name is zolpidem) was approved by the FDA in the early 1990s, it was supposed to be an improvement over the benzodiazepines like lorazepam (Ativan) and triazolam (Halcion) because it acted in a more targeted way and didn't stay in the body as long. Other nonbenzodiazepines were subsequently approved, including Sonata (zaleplon) and Lunesta (eszopiclone).

But when I see patients who are taking Ambien, they have usually gotten the prescription elsewhere, because I am reluctant to prescribe it. As a geriatrician, I treat older patients, and sleeping pills, in general, are problematic for older people. They lead to grogginess the next day and may contribute to cognitive problems, poor balance, and falls. This is also true of over-the-counter sleeping pills like Sominex and nighttime pain medications like Tylenol PM, which contain diphenhydramine (the active ingredient in Benadryl), an antihistamine with a sedating effect that may be mild and safe enough in a younger person but can be overpowering in an older one. Diphenhydramine also has a long list of side effects, including urinary retention, confusion, and constipation.

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