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Ask the Sleep Doctor – Topics: Ambien, Medical Marijuana and Sleep, and Sleep Apps

Dear Dr. Rosenberg,

My mom is 72 years old. She is my dad’s caregiver as he has Alzheimer’s. She has been taking Ambien for a year and her new doctor thinks it’s inadvisable for her to take it, especially in view of my dad. What do you think?

ANSWER:

I think you mother has a very smart doctor. A study just published in the journal Sleep was very telling. Healthy men between 20 and 50 were tested both for the ability to awaken and balance after awakening while on a sleeping pill like zolpidem (Ambien). 60% of the men did not awaken to a sound of 110 decibels through earphones. 110 decibels is equivalent to the intensity of sound at a rock concert. They also tended to have balance issues upon awakening. As your mother may need to respond to your dad’s needs, as well as the fact that at her age hip and skull fractures have been found to be more common on Ambien, I would agree that discontinuation is probably the prudent thing to do for both of their sakes.

Dear Dr. Rosenberg,

My son has had trouble sleeping for years. Recently he got a medical marijuana card. He smokes every night and says it helps him to fall asleep. Are there any downsides to this?

ANSWER:

Great question. There is an explosion of research on marijuana and sleep. The most positive results have been with the synthetic forms of THC (tetrahydrocannabinol) such as nabilone and dronabinol. The problem with smoking the less specific plant form is that habituation is frequently a problem. Some users find that they need to smoke ever-increasing amounts or stronger strains. The other problem is if he wants to stop, it may take up to 45 days during which nightmares and insomnia can be very severe. In fact, the most common cause for relapse in people trying to get off marijuana is sleep-related complaints.

Dear Dr. Rosenberg,

My phone has one of those sleep apps and I have been tracking my sleep. I place the phone under my sheet. It says that I am not getting much deep sleep. I feel ok but I am concerned about what my tracker is showing. Should I see a sleep specialist?

ANSWER:

No!! These trackers have been shown, when a simultaneous EEG is performed, to be incapable of differentiating stages of sleep, and as a result light vs. deep sleep. They also tend to overestimate sleep time and underestimate time to sleep. They are basically motion detectors. In fact, the ones that are placed in your bed but not worn on the wrist are the most inaccurate. They can pick up movement of your bed partner or a pet and misattribute it to you. They have some value in detecting trends in your sleep or detecting circadian misalignments of your sleep with your work schedule, but too many folks are taking them at face value. They are not that accurate yet.

Dear Dr. Rosenberg,

My son was involved in a car accident two years ago. He suffered a whiplash injury and a concussion. Since then he has had trouble sleeping. He wakes up repeatedly and is always irritable. He never had trouble sleeping before and he was a very mellow young man. Could there be a relationship? His healthcare provider doesn’t think so.

ANSWER:

Yes, very much so. We have had numerous studies recently that show that up to 40% of people suffering concussions develop significant sleep-related issues such as insomnia, sleepiness, and inability to remain asleep. In fact, these problems can persist for many years. I would recommend you have him seen by a neurologist and/or a sleep specialist who is familiar with sleep issues after TBI (traumatic brain injury). These issues are treatable.

Dr. Robert Rosenberg, D.O., FCCP, DABSM

Robert S. Rosenberg, DO, FCCP, is the medical director of the Sleep Disorders Center of Prescott Valley, Arizona and sleep medicine consultant for Mountain Heart Health Services in Flagstaff, Arizona. Dr. Rosenberg is board certified in sleep medicine, pulmonary medicine, and internal medicine. His book Sleep Soundly Every Night, Feel Fantastic Every Day  is a best seller. Dr Rosenberg’s latest book is The Doctor’s Guide to Sleep Solutions for Stress & Anxiety. Visit Dr Rosenberg’s website WWW.AnswersForSleep.com which is a wealth of information on sleep topics.

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One Reply to “Ask the Sleep Doctor – Topics: Ambien, Medical Marijuana and Sleep, and Sleep Apps”

  1. Gal A.

    Dear Dr Rosenberg.
    I am taking SSRI – Cipralex 15 mg (following an anxiety) for long periods during the last 18 years. since the beginning (18 years ago) i kind of “lost my sleep” and i was prescribed with Xanax ever since.
    I was able to maintain my sleep with 1 mg of Alprazolam/Xanax till recently.
    now, i find my self taking 1.5 mg and its not always help.
    i am scared.
    the biggest problem was and still fall asleep. it became harder.
    is it still treatable?

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