Sound Sleep Health recently helped KOMO News 4 parse out the puzzling aspects of a recent 9-1-1 phone call. The call was made by a Renton man reporting that he'd been in a small plane crash.
Here's what happened and what you need to know about Ambien (a prescription sleeping medication) and its relationship to sleep behaviors known as parasomnias:
Waking dream turns into a nightmare
What started out as a call for help during the very early morning hours of May 12 did not, in fact, involve a downed small cargo plane, but a disoriented 75-year-old man who had taken the prescription sleep aid, zolpidem, more popularly known as Ambien, and had suffered sleep hallucinations as a result.
These hallucinations amount to a phenomenon known as parasomnia: periods of unusual behavior that take place during transitions between sleep stages and arousals. While many parasomnias are full-fledged sleep disorders (such as sleepwalking, nightmares, or REM Behavior Disorder), sometimes these behaviors happen as the result of using a sleep aid, which can give rise to hallucinations that take on the qualities of waking dreams. (Read more about parasomnias here.)
The caller sincerely believed that he'd participated in a plane crash at the time he'd phoned 9-1-1 for help. (Partial transcripts of the man's phone call to 9-1-1 appear at the KOMO 4 News website.)
Call centers apparently receive quite a few calls from people experiencing vivid Ambien hallucinations, according to this KOMO 4 News report. The dispatcher who received this particular one characterized the caller as being "very calm during the call," but that he "sounded scared."
After listening back to the recording of the call, the dispatcher insisted it sounded very real and that she would never have known the man was hallucinating, had the caller not called back 15 minutes later and told her that it had all been a dream.
Still, the phone call had been so authentic in nature that 7 units, including several fire engines, responded to the report.
Sound Sleep Health in the news
Sound Sleep Health sleep physician Dr. Gandis Mazeika was quick to testify to the authenticity of the Renton caller's very intense experience with the drug when KOMO 4 News asked.
"It must have seemed really real to him for him to call 9-1-1," Dr. Mazeika said, agreeing that it "does speak to some of the potency of Ambien."
The caller's story may come across as amusing to some, but he expressed real concern about the side effects, which occurred after he took just half a dose of the pill in order to sleep after surgery.
It is presumed that he'd had such a strong response to the sleep aid because he had just had surgery earlier that day. There could have been some enhancement of the drug's qualities due to the presence of other drugs in his system that, post-surgery, had not yet been fully metabolized.
Dr. Mazeika points out that, as one of the most popularly prescribed sleep aids in the US, Ambien is considered safe, but that doesn't mean there aren't side effects. "It can cause people to have this kind of disorientation if given inappropriately to a patient or if the dosage is too high," he said.
What is Ambien (generic: zolpidem)?
This federally controlled substance (C-IV) is a sedative-hypnotic medicine used in adults occasionally to treat insomnia. It can lead to dependence and abuse. It's illegal to sell or give it away to others due to the potential harm of using it without being under the careful observation of a healthcare provider.
Ambien has become widely available, however, with patients not always aware of its side effects. According to Dr. Mazeika, hospital emergency room visits related to Ambien tripled between 2005 and 2010, with many affected being women and people over the age of 45.
The concern over potential parasomnia-related side effects spurred the Food and Drug Administration (FDA) to adopt new guidelines reducing dosages for women and seniors to curb safety concerns. Previously, a 10mg dose was available to all users, but that amount has since been reduced by half for these two patient populations.
Some people do not respond at all to Ambien, while others find it works well for them on the occasions when they do use it. If you have never taken Ambien, you may not truly know how it affects you until you do.
It is recommended by Dr. Mazeika and other sleep specialists that first-time users start it on a weekend, or when they won't be expected to rise early and drive to work, to learn how they might respond to it.
Remember, not all people respond to drugs in the same way, so your results may be very different from your friend's or family member's results.
What are the side effects of Ambien?
These side effects are cited directly from the FDA medication guide for zolpidem (Ambien):
After taking Ambien, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night. You have a higher chance for doing these activities if you drink alcohol or take other medicines that make you sleepy with Ambien
Reported activities (forms of parasomnia) include:
- driving a car ("sleep-driving")
- making and eating food
- talking on the phone
- having sex
Abnormal thoughts and behavior, including more outgoing or aggressive behavior than normal, confusion, agitation, hallucinations, worsening of depression, and suicidal thoughts or actions.
Severe allergic reactions that can include swelling of the tongue or throat, and trouble breathing
Grogginess or feeling as if you have been drugged (popularly referred to as the 'Ambien hangover')
You are also advised to never take Ambien if you:
Drink alcohol that evening or before bed
Take another medicine to help you sleep
Should Ambien users be concerned?
Dr. Mazeika emphasizes that Ambien should only be used under the care of a physician. If you have used it and have not experienced alarming side effects, "this should not be a warning to stop taking it," he said.
While stories like the caller's often quickly circulate the Internet, they do not represent the reality for most users. If taken as advised, as an occasional defense against insomnia, Ambien is usually harmless.
It also helps countless patients achieve sleep onset who otherwise might not be able to do so. It is frequently used in the sleep clinic for this reason: it helps anxious patients to relax and fall asleep at the beginning of their sleep studies because it can, in fact, be very effective.
KOMO 4 News
Food & Drug Administration (FDA)