Switching from ambien to temazepam

I've been taking ambien for about two months. I started at 10mg and slowly worked up to 17.5 mg (1 3/4 tablets). When I take it, I'm out like a light in about 15 minutes, and sleep soundly for about 5 hours, and then doze in and out for a few more hours.

I saw the sleep study doctor yesterday, and he gave me a prescription for temazepam, 15mg, and said I could take one or two at night. He said it should give me 6-8 hours of sleep. Last night I took 15mg, and did not sleep well at all. I awoke every hour, sometimes every half hour.

Is it OK to just switch from ambien to temazepam like that, abruptly quitting the ambien? Should I alternate back and forth for a while? And lastly, should I sleep better or at least as good with the temazepam and maybe 15mg just isn't enough? Last night was not good - I'm not sure if I should take more temazepam or just stick with the ambien.

[Alison L, RPh]

You really need to discuss this with your physician. Some people do find it helpful to alternate sleep medications. Temazepam is usually used to help patients stay asleep for longer periods, however, since it is considered more addictive, it isn't always prescribed by sleep specialists. If you felt like the Ambien worked better, you may want to ask your doctor about the extended release version because that may help you stay asleep longer.

[Zootal]

Thanks for your comments. We talked about ambien extended release, but that stuff costs over $200 for 30, as opposed to about six bucks for 60 10mg tablets of the generic non-extended release. I wanted it but simply can't afford it. So I went back to the regular ambien - it doesn't last as long, but as you say is not as addictive. I can usually doze in and out after it wears off, so it is at least tolerable. My Dr. says I'll be on it for another month or two, as it will take time to get weaned off of it.

[woodarcr]

Also you should conciser what is causing you to have problems sleeping. One very common cause of insomnia is sleep apnea, where you stop breathing in your sleep. Others include poor sleep hygiene and stress. Only taking medications (regardless of how strong) will not cure problems caused by lifestyle.
Sleep medications are only clinically proven for the SHORT-TERM treatment of insomnia and are not intended to be taken for an extended period of time. Ambien may not be chemically addictive but it is psychologically addictive. You feel like it will help you sleep, so you sleep better. Then you stop taking it, worry about waking up and therefore don't sleep as well. If you don't do anything else to help your sleep habits it just won't work!
Some things you should be doing to help cure your insomnia are:
1. Reserve your bedroom for sleep only. No tv in bed, no reading etc.
2. Don't have caffene after 2pm or so
3. Get regular exercise, so that you will be tired!
4. Wake up at a set time every day, and no naps!
5. Reduce any stress that you may have.

Furthermore, tamezepam is a very addictive substance, as is xanax and they are in the same family of drugs. Why are to taking the xanax exactly? your current medical problems are insomnia and hypertension, neither of which would be treated with daytime xanax.

[Zootal]

I don't have anxiety in my profile - I should update it. I don't sleep because my breathing slows down so much my blood oxygen drops to the low 90's and I wake up gasping for breath. I still breath - just at a low rate. And everyone tells me they have never quite seen that before, and it's probably anxiety. Accompanying this are general anxiety symptoms - chest pains, heightened sensitivity, gag reflex, emotionality.

So the ambien masks the feeling of being out of breath and gives me about 4-5 hours of sleep. With luck I can doze for a few hours more before it wears off to the point where I go back to gasping for breath. On bad nights I'm awake at 3:30am and lucky to have slept for four hours. Dr. did an overnight blood oximetry test, showed my blood O2 level in the low 90s - not low enough to require me to be on oxygen, but low enough to keep me from sleeping. I can't even take naps - I nod off and within minutes wake up gasping for breath.

Until my breathing improves, I'm stuck on the ambien. I hate the stuff and wish I didn't have to take it, but without it I get no sleep at all.

My primary care Dr. gave me the xanax for short term usage and told me I was suffering from anxiety. That has led me down the pathways to therapy, sleep study, a urologist that thinks my pain is in my head, lots of self-help books, an emergency room visit, visits to a chiro who tells me it is adrenal gland related, and now I don't know what to think about what is going on.

I've decided not to use the temazepam. Ambien is a lesser evil, and easier to get off of, so I think I'll just stick with it. I know this will clear up eventually, and when I can breathe again at night, then I'll deal with getting off of the ambien.

[woodarcr]

If your problem is not getting enough O2 during sleep, you may want to conciser talking to your doctor about getting a CPAP machine. Its basically a mask that you wear while sleeping that gently pushes air into your lungs to keep your breathing strong and regular while you sleep. It may take awhile to get used to, but many patients find it is wonderful for helping them sleep. Also, if you know you have it to protect you from gasping for air, you may be less anxious while sleeping!  
Also, it does sound like your main problem is anxiety. Although xanax helps with short-term panic symptoms there are other medications that can help you in the long-term. An example would be an SSRI or selective serotonin re-uptake inhibitor (drugs like celexa, prozac, paxil etc) that increase levels of neurotransmitters in your brain and help with anxiety problems. They are safe, non-addictive and generic (cheap!).  I would talk to your doc about that! :)

[allmymarbles]

I was an insomniac for 30 years. It became a very serious condition in terms of my health. I found the cause of my sleeplessness quite by accident. I was lacking in iodine. I started taking it and slept normally for the first time in decades. (It takes a couple of months to kick in completely, but improvement is immediate.)

Try about 3 drops of 5 per cent Lugol's solution a week (one drop on Monday, one on Wednesday, and one on Friday). That is a normal supplement dose for someone of your weight. If you sleep better then you won't need drugs to help you. If it doesn't work, then you have done yourself no harm.