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Lunesta vs. Ambien: Insomnia Medications

Sleep disorders like insomnia are among the most common disorders that American’s face. In fact, the Centers for Disease Control and Prevention report that as much as a third of Americans don’t get the sleep they need each night. To combat problems like insomnia, doctors use prescription sleep aids like Ambien and Lunesta. 

Both Lunesta and Ambien are in a unique category of drugs called non-benzodiazepine sleep aids. They are also called Z-drugs because their generic names often include the letter Z. These prescription medications are similar to other central nervous system depressant sleep aids that have been used in the past like barbiturates and benzodiazepines. 

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However, they are a unique chemical structure, and they are generally milder than their predecessors. They are less likely to lead to dangerous overdoses or addictions than other depressants, though it’s still possible to encounter these issues if the drugs are abused. 

Lunesta and Ambien are both used as short-term therapeutic treatments for insomnia and other sleep problems. Though they aren’t as potent as benzos or barbiturates, studies have shown their efficacy to both help you fall asleep faster and stay asleep longer. The drugs are used in short-term therapeutic use because their likelihood to lead to negative side effects like dependence and addiction increases with long-term use. It may also cause you to build up a tolerance, making it less effective as a sleep medication.

As depressants, Lunesta and Ambien may cause intoxication that’s similar to alcohol in high doses, which means that they may sometimes be used as recreational drugs. Abusing the drugs causes side effects, including addiction and withdrawal, more likely.  

How Lunesta and Ambien Work

Both Lunesta and Ambien are central nervous system depressants that work by decreasing brain and nervous system activity. They work to suppress excitability in the brain in a way that facilitates sleep. Like alcohol, benzos, and barbiturates, these sleep-aids are GABAergic, which means they work by affecting a chemical messenger in the brain called gamma-aminobutyric acid (GABA). This natural neurotransmitter is responsible for regulating excitability in the brain. 

In people with insomnia or sleep disorders, GABA may not be enough to relax your nervous system on its own. This may be because of a biochemical or psychological problem that’s causing alertness, anxiety, and wakefulness when it’s time to rest and relax. 

GABA binds to its receptors in the brain to slow down your nervous system. Ambien and Lunesta both work by binding to other spots on those same receptors and increasing the effectiveness of GABA. Ideally, this will lead to relaxation that allows you to fall asleep faster and stay asleep longer. In high doses, it can cause drowsiness before you are ready to sleep or when it’s time to wake up. It can also cause slurred speech, loss of motor control, and disinhibition. Lunesta and Ambien affect the brain in similar ways, though they may have different onsets and durations of actions. 

How Are They Different?

Lunesta and Ambien are both fairly similar in their effects and the way they work in the body. However, they are slightly different when it comes to a standard dose and how long they last. Lunesta is a little more potent and lasts longer than Ambien. So, a typical dose of Lunesta will be smaller than a typical dose of Ambien. An immediate-release tablet of Ambien calls for 5 mg per day for women and 5 mg to 10 mg per day for men. Lunesta calls for 1 mg per day for men and women.

Lunesta has a longer half-life of six hours compared to Ambien’s 1.5-hour half-life. This means that Lunesta will remain active in your system for longer, which means that it might be a better choice if your problem is waking up in the middle of the night or not sleeping long enough. 

Side Effects of Sleep-Aids

High doses or long term use can lead to tolerance and dependence. Your brain may start to adapt to the presence of the drug in your body. It may decrease some of it’s on inhibitory chemicals and increase more excitatory chemicals in order to counteract the drug. This can cause you to need higher or more frequent doses to achieve the same effects. This can also lead to dependence when your brain comes to rely on the medication to maintain a normal chemical balance. If you stop using the drug or cut back, you may start to experience withdrawal symptoms.

Depressant withdrawals are unique because they are the only major drug class to cause potentially life-threatening withdrawal symptoms. Depressants like Ambien and Lunesta can suppress excitability to the point that the brain gets used to it. When the drug is removed from your system, you will experience over-stimulation in the nervous system. One of the most common symptoms of this is rebounding, which is when the problem you intended to remedy (in this case, it’s insomnia) return when you stop taking the drug. You may also experience anxiety, irritability, tremors, muscle spasms, sweating, and mood swings. 

The most dangerous symptoms of depressant withdrawal are seizures and a condition marked by confusion, panic, and heart-related complications called delirium tremens. These symptoms are less likely to be seen in Lunesta and Ambien withdrawal that other depressants. However, it’s possible, especially if you’ve gone through depressant withdrawal before. A neurological phenomenon called kindling can cause long-lasting changes in the brain to form after you go through depressant withdrawal. These changes can make subsequent withdrawal periods more intense and even deadly. 

Seeking Help for Addiction

If you or someone you know has been using Ambien or Lunesta and might be developing a chemical dependency, it’s important to seek help sooner than later. Substance use disorders can get worse without effective treatment. Addiction is a progressive disease, and it can start to take over different parts of your life, like your health, relationships, and finances. 

However, with addiction treatment, substance use problems can be addressed before they can start to cause some of these severe consequences. When it comes to depressants like prescription sleep-aids, it’s important to speak to a doctor before quitting cold turkey, because withdrawal can be dangerous. To take your first steps toward recovery, learn more about addiction, and how it can be treated today.

Sources

Becker, H. C. (1998). Kindling in Alcohol Withdrawal – National Institutes of Health. from https://pubs.niaaa.nih.gov/publications/arh22-1/25-34.pdf

Centers for Disease Control and Prevention. (2018, February 22). CDC – Sleep Home Page – Sleep and Sleep Disorders. from https://www.cdc.gov/sleep/index.html

Krystal, A. D., Erman, M., Zammit, G. K., Soubrane, C., & Roth, T. (2008, January). Long-term efficacy and safety of zolpidem extended-release 12.5 mg, administered 3 to 7 nights per week for 24 weeks, in patients with chronic primary insomnia: a 6-month, randomized, double-blind, placebo-controlled, parallel-group, multicenter study. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2225552/

U.S. National Library of Medicine. (2004, September 16). gamma-Aminobutyric acid. from https://pubchem.ncbi.nlm.nih.gov/compound/gamma-Aminobutyric-acid

U.S. National Library of Medicine. (2019, September 11). Delirium tremens: MedlinePlus Medical Encyclopedia. from https://medlineplus.gov/ency/article/000766.htm

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