Why Ambien and Alcohol Don’t Mix

After yet another night of tossing and turning, you decide to ask your doctor about medications for insomnia. You’ve only heard of one — Ambien — but you’re not sure whether it’s a good fit for your symptoms. It seems like a pretty serious drug; can you even drink while taking it?

No, you can’t mix alcohol and Ambien. Why not?

Today, we’re exploring the dangerous combination of taking Ambien with alcohol. We’ll also answer your frequently asked questions about this sleep med, including “Is Ambien addictive?” and “Can you take Ambien every night?”

Ambien Explained

Ambien, available under the generic name zolpidem, is a prescription drug used to treat insomnia — difficulty falling or staying asleep — in adults. It’s part of a drug class called “sedative-hypnotics,” which includes most sleeping pills and tranquilizers.

Ambien works by activating a neurotransmitter called GABA (gamma-aminobutyric acid, for our fellow neuroscience fans), which inhibits neuronal behaviors responsible for insomnia. It’s so strong that most of us will be out like a light within 30 minutes of taking it.

Despite that efficacy, zolpidem isn’t prescribed much these days. There are three reasons that Ambien has fallen from popularity: its harsh side effects, addictive potential, and severe interactions with substances like alcohol.

Side Effects of Ambien

Like any medication, Ambien is associated with side effects. While some issues may only manifest when starting the drug or upping our dose, we should talk to our doctor about those that don’t improve over time. The following are considered common complications of zolpidem:

• Drowsiness
• Headache
• Nausea
• Dizziness
• Feeling lightheaded or “drugged”
• Motor side effects: stumbling or struggling to balance
• Gastrointestinal side effects like constipation, gas, or diarrhea
• Tingling, shaking, or numbness in our arms, hands, legs, or feet
• Strange, vivid dreams

Doctors classify certain side effects as severe; if we experience any of these, we should immediately seek medical attention:

• Signs of an allergic reaction (hives, itching, swelling, rash)
• Shortness of breath
• Yellowed skin or eyes (jaundice)
• Chest pain
• Delusions (thinking things that aren’t true)
• Memory loss
• Hallucinations (seeing or hearing things that aren’t there)
• Vision changes including blurred vision
• Vomiting
• Pounding heartbeat

When people talk about the bad side effects of Ambien, they’re usually talking about the dangerous sleep behaviors associated with this drug. While under the influence of zolpidem, some patients have gotten out of bed and driven their cars, sleepwalked, prepared food, or initiated sex with their partners. They were fully unaware the entire time. Upon waking, they could not remember doing any of it. If we learn that we have engaged in any activity while taking Ambien, we should discontinue the medication and contact our doctor immediately.

Is Ambien Addictive?

While Ambien is technically less habit-forming than benzodiazepines (Valium and Xanax, to name a few), it still has a high addictive potential. Our body becomes accustomed to the neurochemical changes associated with the drug, which means that we might develop a tolerance for zolpidem and need more of it to achieve the same effect.

We may also experience withdrawal symptoms like irritability, rebound insomnia, anxiety, and even seizures when we skip a dose. This occurs because the brain expects Ambien-induced neurochemical activity every night. When that doesn’t happen, our brain kicks into high gear in an attempt to reach equilibrium.

At the same time, we begin to associate Ambien with sleep and may doubt our ability to get a good night’s rest on our own. Some people take more of the drug than recommended or ask their doctor to continue prescribing it. Over time, this combination of physical and psychological dependence can develop into a full-blown addiction.

Can You Take Ambien Every Night?

So, is it safe to take 5mg of Ambien every night? What about 10mg?

We can take Ambien every night for the duration of our treatment, which should not exceed six weeks. Most of us will only receive prescriptions lasting between a few days and four weeks. This is because the FDA specifically cautions providers that long-term administration of this drug is not recommended, and “treatment should be as short as possible.”

To put it more directly: we may take Ambien every night while it is prescribed to us, but we probably won’t be on it for very long. Part of the reason for the FDA’s warning is the risk of dependence (as outlined above). Another deterrent is Ambien’s strong interaction with other central nervous system (CNS) depressants like alcohol.

Alcohol and Ambien: A Dangerous Mixture

Both Ambien and alcohol are CNS depressants, which means they slow down our brain’s activity. When combined, the depressant effects of both the drug and the drink are doubled, which impairs us further and makes us vulnerable to life-threatening health problems.

For example, combining alcohol and Ambien can cause severe levels of sedation, cognitive impairment, and worsened motor functioning. This makes us more likely to fall, accidentally injure ourselves, or make poor decisions with lasting consequences.

However, there’s a much bigger risk of mixing these substances. Together, Ambien and alcohol may cause respiratory depression. This is the medical term for slow, shallow breathing that causes carbon dioxide to build up in our blood and reduces the amount of oxygen that can reach our lungs. We may not realize anything is wrong and think we’re just falling asleep. Our loved ones might observe symptoms like labored breathing, blue skin, nausea, headache, and fatigue. Respiratory depression is a leading cause of fatal overdoses.

Stay Safe While Taking Ambien

If your doctor has prescribed Ambien, they have determined that the benefits of this drug outweigh the downsides associated with it. By following their advice and the medication guidelines, we can stay safe while taking zolpidem. There are a few best practices we can follow while on this medication:

• Take Ambien exactly as prescribed. Never take more than the recommended dose, even on a particularly hard night. It’s always best to contact our medical team with questions about dosage and efficacy.

• Don’t take risks. Activities like driving or cooking with sharp objects require a lot of mental alertness. They can also quickly go wrong if we’re not careful! Never drive or handle dangerous objects after taking a sedative.

• Stay on schedule. A consistent sleep schedule can help us maximize Ambien’s effectiveness, improve our sleep quality, and create a routine that works for our needs.

• Store it safely. Keep prescription medications in a cool, dry place according to package instructions while also ensuring they remain out of the reach of children or pets.

• Report serious side effects. It’s important to stay open with our medical team about any issues we have after starting Ambien. If we experience persistent or severe side effects, or if our loved ones have noticed us engaging in activities while under the influence of this medication, we should immediately reach out to our doctor.

• Avoid alcohol. Finally, steer clear of alcoholic beverages while taking zolpidem. Combining Ambien and alcohol places us at risk of respiratory depression, which may be life-threatening.

Before starting any new prescription drug regimen, it’s a good idea to do some research about the way your meds can interact with substances like alcohol. 

When Can You Safely Take Ambien After Drinking?

Because of the risks inherent in mixing these two substances, it’s best to abstain entirely from alcohol while taking Ambien.

If we must imbibe, it’s crucial to wait for alcohol to completely leave our system before taking this sedative-hypnotic medication. How long that process takes depends on our weight, gender, and what we drink.  

While the internet is full of estimates — for example, it generally takes an hour for the average person to metabolize a standard drink versus 14 to 17 hours to clear Ambien from their system — it’s best to talk to our doctor instead of guessing when it’ll be safe to take sleeping pills after drinking. The risks are too great to leave it up to chance.

Most medical professionals will assure us that it’s never a good idea to combine Ambien and alcohol. If we’ve been prescribed this drug and drink often, we should discuss our alcohol intake with our primary care provider and come up with a new plan moving forward. After all, there are plenty of substitutes for zolpidem.

Alternatives for the Always-Awake

Ambien isn’t the only option for those of us struggling with insomnia. To improve our sleep quality without taking zolpidem, let’s consider other medications, herbal remedies, supplements, and behavioral changes.

Other Prescriptions

First, we can talk to our doctor about prescription alternatives to Ambien. Sleep aids like Lunesta (eszopiclone), Sonata (zaleplon), and Vistaril (hydroxyzine) are popular options. These medications use different methods of action and may better meet our needs. Depending on our experience with Ambien or concerns about the drug, our provider might choose to prescribe one of these substitutes instead of zolpidem.

Herbal Remedies and Supplements

We may also want to explore the wide variety of herbs and supplements on the market. Many of us have probably taken melatonin to help with insomnia, which is a hormone available in the form of pills or teas. If that hasn’t worked in the past, we can consider valerian root, chamomile, lavender, green tea, and magnesium, which are all recommended for those struggling to sleep.

Lifestyle Changes

Finally, behavioral changes can make a massive difference in our insomnia. Establishing a consistent bedtime and practicing mindfulness are two easy ways to prime ourselves for a good night’s rest. We can also cut back on caffeine, naps, and screen time, which all disrupt our sleep-wake cycle. Incorporating regular exercise into our routine can also contribute to some well-timed, much-needed exhaustion.

Slumber, Not Spirits

Now we know that mixing Ambien and alcohol is a bad idea — in fact, drinking while on this drug can be life-threatening. Because both substances are CNS depressants, we may be more likely to experience side effects like dizziness, falling, confusion, difficulty concentrating, and respiratory depression when we combine them. In short, drinking on Ambien is never worth the risk.

Fortunately, there are plenty of ways to address sleep disorders without Ambien. Alcohol may play a role in our insomnia. If we’re looking for relief from sleepless nights, we may want to start by reevaluating our relationship with alcohol. Drinking disrupts our sleep-wake cycle, which increases our risk of issues like insomnia.

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