The Ambien Incident

I often take a sleep aid when I'm not on call.  If I don't, and I've been up a lot the preceding nights, I tend to wake up at 2 A.M. and stay awake. This doesn't do much for my bedside manner the next day. Taking a sleeper on non-call nights has always seemed like a safe thing to do, until recently. Here's the story:

I'd come off seven days of hospitalist shifts, and was about to enter seven nights of the same. There was one night off in between those weeks, so it seemed critically important to take a sleeper in order to catch up. At 10 P.M. I took an Ambien and went to bed.

At 2 A.M., the phone rang. It was one of the obstetricians. "We're going to C-section and there's no RN first-assistant on call."

"Well, I just got off a tough week of hospitalist, so I'd rather not come in," I said dreamily.

"OK, I'll call everybody else. If I can't get anyone, I'll call you back."

I fell asleep cradling the phone. When it rang again, I picked it up right away.

"We do need you, Theresa," the OB said.

"OK, I'm on my way."

I got out of bed, changed into OR scrubs, got in my car, drove to the hospital, walked into the building, into the OR, said hi to the OR staff, scrubbed, gowned, climbed up onto the footstool I always have to use because I'm so short, blotted/retracted/followed suture as commanded by the OB, cut the umbilical cord, congratulated the mother, stepped away from the operating table when the OB dismissed me, de-gowned, de-gloved, walked out of the building, got into my car, drove home, changed back into pajamas, and went back to sleep.

The next morning, I didn't remember any of it.

Slowly, after a couple of cups of coffee, images began to filter in, starting with the memory of cutting the cord, then looking across the table at the OB. They came back to me like snippets of a dream. In fact, I believed it was all a dream until a momentary doubt made me look in the laundry hamper.

On top of the hamper, I found a pair of OR scrubs.

Moral of this story: if you're not on call, turn the damn ringer off the phone.

Self-care

Comments

[Sara Anderson]

I've been reading a lot about Ambien problems, and in my experience, if you're REALLY not going to sleep, then it won't make you do anything crazy, just sleep.

I've never fallen asleep in the middle of anything - reading, watching TV, etc. - but Ambien puts me to sleep within 15 minutes, which I can't do on my own. Let alone within an hour.

P.S. I'm a rural patient who's been kind of driving her GP crazy over the past year. So you (and she) have my sympathies.

[Doc]

Ambien's a potential bummer. Expect more of these stories now that it's generic. I have insurers faxing requests to switch from benzos to Zolpidem. (The same insurers who asked me to use the benzos instead of Ambien, Sonta, etc. in the first place!)

One of my first patients that I placed on Ambien, informed me that her husband kept thanking her for the "great nights," and she had no recollection...

I also have seen a number of sleep-eating sessions, usually with messy results. Apparently it can give one the munchies, as well as amnesia.

Nice blog! I have always viewed myself as trying to be like the old country doctor, in my humble private practice.

[Dragonfly]

Advice engraved in brain!!! Thanks :-)

[Peggikaye]

My insurance allows enough ambien for about 15 days of the month. My lupus causes significant insomnia. I always swear when I'm on it, I'm going to stop taking it, then, I run out ..and I don't sleep for 2 weeks (well, about 2 hours a day for the whole 2 weeks, sleep study revealed the ambien took 3 hours before I fell asleep, & even with it, I'm not sleeping well)

The amnesia effect is terrible. Conversations, activity, sleep walking, showering, eating ...

so far nothing dangerous.

But then I run out, and I do what I've done for the last 10 days, and go without sleep and wonder which is the lesser of the 2 evils as I go into a flare from lack of sleep.

I can't imagine what would happen if i were to drive ...