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Diagnosed with epilepsy and have insomnia. Will it be safe to take ambien?

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Practicing since : 2003
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I have been having a difficult time sleeping for the last several months. I was diagnosed with epilepsy over the summer and was told that insomnia can lead to seizures. I would like to avoid this if at all possible. I have heard some really good things about Ambien, and would like to try it if at all possible.
Posted Sun, 16 Dec 2012 in Epilepsy
Answered by Dr. Jonas Sundarakumar 14 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you are going through a difficult time due to your inability to sleep properly. Ambien (Zolpidem) is a non-benzodiazepine sedative medication which has a short duration of action, very low addiction potential and minimal side effects like 'hangover' or daytime drowsiness, decreased concentration, etc. Though it is helpful in treating sleep problems, yet it is better to have a proper assessment of your sleep problem before starting yourself on any medication.

Now, difficulty in sleeping (known as "insomnia" ) can be due to a variety of causes. Some of the problems causing insomnia are:
- Stress
- Anxiety
- Depression
- Poor sleep habits
- Other medical problems, chronic pain, etc.

So, the first step in managing insomnia is a detailed assessment to establish the probable cause. Further treatment is then targetted according to the cause.

There are also certain sleep hygiene techniques which can be helpful in improving sleep irrespective of the cause of insomnia:
- Fix a specific bedtime and an awakening time. Do not allow bedtime and awakening time to drift.
- Avoid napping during the day.
- Avoid coffee, tea or any caffeinated drinks or alcohol 4 hours before bedtime.
- Avoid heavy, spicy, or sugary foods for dinner. Have a gap of at least 1 hour between dinner and bedtime.
- Exercise regularly, preferably in the early evening, at least 4 hours before bedtime.
- Set up a comfortable environment which is dark, quiet and disturbance-free. Block out all distracting noise, and eliminate as much light as possible.
- Reserve the bed for sleep only. Don't use the bed for studying, working or for other rectreational activities.
- Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
- Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
- Don't take your worries to bed. Leave your worries about studies, work, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.
- Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.

So, I would also advise you to first consult a doctor, preferably a psychiatrist, for a detailed psychological assessment, to see if you may be having any stress or anxiety-related problems, which may be causing your insomnia, and for which you may need further treatment. It is also better to take medication under the supervision of a doctor, since you may need monitoring regarding side effects, dose adjustments, duration of treatment, etc.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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