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Sleep Disorders

Ambien Restoril in Combination For Sleep

11/05/2008

Question:

Can Ambien be taken with Restoril if Ambien alone does not induce sleep?

Answer:

Combining 2 different sleep aids to help you get to sleep is, in general, not a good idea. So strictly speaking, I would say no.

Ambien is in the class of nonbenzodiazepine sedatives that are used to help with insomnia and are generally well-tolerated, though side effects can occur. Restoril is in the class of benzodiazepine sedatives and can be used as a sleep aid as well, though is generally not recommended for long-term use.

Combining these 2 medications raises concern for depression of the nervous system, which could lead to severe sedation, risk of decreasing respiratory drive (leading to impaired breathing) and poor motor function. In other words, the combination could be dangerous. While there may a circumstance where these two could be used in together, it should only be under the close supervision of a physician. Personally, I would never prescribe the two together. As another word of caution, neither of these medications should be taken with alcohol. Alcohol is another nervous system depressant that, when combined with sedatives, can be very dangerous.

Often times, problems with insomnia can be managed with approaches other than medications. Recent studies have suggested that cognitive behavioral therapy can be just as effective (if not better than) medications. If you are having considerable problems related to insomnia, you should probably be referred to a Sleep Specialist for additional evaluation. Most conditions associated with insomnia can be treated to some degree of success and the key lies to sorting what factors in each specific case need to be addressed.

To learn more about insomnia or other sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you. 

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Response by:

James   Knepler, MD James Knepler, MD
Formerly, Assistant Professor
College of Medicine
University of Cincinnati