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At the peak of my sleep crisis, I was an Olympic endurance insomniac, often awake for 48 hours straight. During those endless stretches of time, I watched TV, called friends in California, whimpered, wept, beat my pillow, flipped through tabloids and surfed the Internet. I didn’t write, though I am a writer — I wasn’t capable of forming thoughts, much less sentences. So by the time I turned to the sleep aid Ambien for relief, I was desperate — and primed to become an addict.
And I started abusing it almost immediately: I ignored the prolific warnings on the package, called multiple doctors to get it, mixed it with alcohol and took more than the prescribed amount. The makers of this drug never intended it to be used in any of those ways. And neither did I.
In the past few years, prescription drug abuse has been all over the news: Eminem went to rehab for an addiction to sleeping pills in 2005; John Stamos gave a bizarre interview on Australian television that he later blamed on Ambien; and in January Heath Ledger died in a New York City apartment from a lethal mix of painkillers, sleeping pills and antianxiety medication.
When I heard about Ledger’s death, my first thought was, God, how tragic. My second thought: Could that have been me?
My sleep problems started in 1999, when I was 28. I’d taken a job as a secretary at an investment bank and had to be at my desk by 7:30 A.M. Right off I had trouble adjusting to my new schedule. The workdays went by slowly and the evenings all too quickly, and by the time I got into bed, it was often midnight or later. Knowing I could get only six hours of sleep at the most, I would start to panic. Worrying about not sleeping kept me from sleeping, and by the time my alarm clock sounded, I was lucky if I’d gotten four hours. At work I often found myself ducking into a bathroom stall just so I could sit on the toilet and rest my head against the cool metal wall for a few blessed minutes.
This went on for three years, until I left the bank to become a writer. Since I no longer had to get up early, I simply indulged my body’s natural rhythm, staying up most of the night and sleeping until noon. It wasn’t the healthiest lifestyle, but at least I no longer spent my bedtime hours steeped in anxiety, watching the clock. Then in 2004 I was hired by Glamour as an articles editor. During the day I worked without stopping and at night I attended parties and premieres. When I got home, the last thing I wanted to do was go to bed (I needed time to myself!), so I would flip on the TV or talk on the phone, and by the time I meandered into my bedroom, midnight had long passed.
Soon the old insomnia was back — and it was even worse than before. My bed wasn’t a relaxing place to rest my head; it was a torture pen dressed up in a downy comforter and pretty pillows. Desperate for a remedy, I called my mom, a world-class insomniac herself. She told me she’d been taking Ambien — and that it had changed her life. The next time I saw her, she handed me one of her pills. “See if this helps,” she said.
Did it ever. That night, for the first time in years, I fell asleep instantly, awash in the kind of deep, dreamy slumber I hadn’t experienced since childhood. The next day I woke up refreshed. Convinced I’d discovered the Fountain of Sleep, I called my doctor that same day to ask for my own prescription. He gave me 20 five-milligram doses, which I was to take for “occasional sleeplessness.” For the first few weeks, I was especially cautious, breaking the pills in half and restricting my use to Sunday nights only. But soon I found all kinds of excuses to take half a pill in the middle of the week, too: I had an important meeting; I was going to be on deadline the next day; I had a fancy event to attend after work and needed to look my best. The insert that came with the pills clearly stated that they could be addictive, but I told myself it was better to have a mild drug in my system and to sleep than to be “sober” and spend my days exhausted and depleted.
Before long I needed to take a pill every night. If I tried to fall asleep naturally, I would have what’s called “rebound insomnia,” meaning I would be up all night as a result of taking the drug the night before. Watching the clock creep around to 5 A.M., 6 A.M., then 6:30 A.M., I couldn’t stand it anymore — I would pop a pill, drifting off for an hour and a half until my alarm sounded.
I began running out of my monthly supply of Ambien after 20 days or so. When my doctor wouldn’t renew my prescription before 30 days, I found a second doctor and had him call my prescription in to a different pharmacy. Already deep in denial, I didn’t think “doctor shopping” was illegal (it is) or even a bad idea; I simply thought of myself as stockpiling much-needed supplies. I also didn’t confide in friends about my growing dependence on the drug; I didn’t want to hear any levelheaded suggestions about “switching to warm milk” or “going to bed at the same time every night” (I’d tried both; neither had worked). Nor did I say a word to the therapist I’d been seeing for more than a year. After all, there were so many more vital things to discuss: job pressures, difficulties I was having with friends, dating woes. Once I met a doctor at a party and said, “I think I’m addicted to Ambien.” He laughed and said, “Are you sleeping well? So you’re addicted — no big deal!” My mind at ease, I continued to pop pills.
I was hardly alone. According to a February 2008 report by IMS Health, a pharmaceutical-industry research firm, pharmacists filled more than 54 million prescriptions for sleep drugs in 2007. That’s up 70 percent from 2002. In 2005 pharmaceutical companies netted more than $2.7 billion from prescription medications for insomnia — and with so many ads for sleeping pills routinely featured on television, those numbers continue to rise. A typical sleep-aid ad shows an attractive couple waking up in the morning, beatific smiles on their faces. Just try telling an insomniac to resist a commercial that promises to deliver the Holy Grail: sleep.
One potential side effect of Ambien is “sleep eating” — the odd practice of preparing and eating food while asleep. That happened to me all the time. I’d wake up to find in my bed cheese and crackers and a sharp knife on a plate (hey, at least I was classy). One morning I wandered into the kitchen to make coffee and discovered a pot of soup over an open flame on the stove. I had no idea how it got there.
Several times I had tried to quit by using sheer willpower: Usually by day three I gave in. “F—k it,” I would say aloud, twisting the cap off the bottle with force and tossing the pills into my mouth. I’d quit at some point in the future: when I didn’t need to get up early for work, when my life became more serene, when I had a husband and kids to take care of. But those things never materialized, and I never stopped.
A year into my job at Glamour, I was promoted to senior writer. My new responsibilities included doing celebrity interviews. Most of these interviews took place in L.A., so I had to travel there about once a month. For as long as I could remember, I’d been afraid of flying, but I wasn’t about to give up the most exciting career opportunity of my life. One day, as I was white-knuckling it through a patch of turbulence, I remembered the Ambien in my overnight case. I’d been taking it every night to sleep — why not to fly? I popped a pill and my fear melted away entirely. I woke up five hours later, just as the wheels touched down on the tarmac. After that I never wanted to fly without Ambien in my system again. But before long it took more than my usual dose to ensure I was out cold, so I upped my “airplane Ambien” to nearly 20 milligrams, quadruple the amount I was supposed to be taking. Once, I woke up to find a flight attendant bent over me, listening to my heart. We’d just landed, and everyone was standing up, collecting their bags. I’d remained slumped in my seat, head lolling forward. Passengers were craning their necks to look at me. When I realized what was happening, I brushed the flight attendant’s hands away. “I’m fine,” I said, annoyed. “I thought you’d stopped breathing,” she said, looking deeply concerned.
I drove off in my rental car, still groggy and blinking rapidly in order to stay awake on the highway. (I gave no thought to the fact that I was, for all intents and purposes, driving under the influence.) I was embarrassed about what had happened on the plane and, for the first time, truly scared. I wanted to see what experiences other people were having, so that night in my hotel room, I Googled “Ambien addiction.” I was shocked to find dozens of chat rooms devoted to the subject. “I have run into things, banged my head on my desk and woken up with bruises and a burn on my stomach,” wrote one woman. “I’ve purchased things online, and the only proof I had was an e-mail receipt,” confessed another. Too shy to participate in the discussion (and unwilling to admit the extent of my own addiction), I just lurked online, deliberately looking for posts from people who seemed way worse off than I was. Whoa, I thought as I read about a woman who supposedly wrecked her car while on Ambien with her two young sons in the backseat — at least I’m not that bad.
By then I was involved in a long-distance relationship with a guy I’d met through an Internet dating site. Whenever our marathon phone conversations ran late on a weeknight, I would take my usual dose of Ambien, thinking I’d hang up when I felt tired. But it didn’t always work out that way: If the Ambien failed to knock me out, I would go into a sort of waking blackout. We would have entire conversations I couldn’t remember the next day. Or it would make me strangely hypersexual: We would have entire sessions of phone sex I couldn’t remember. My boyfriend knew I sometimes took Ambien at the tail end of our conversations, but he didn’t seem to suspect it was fueling my adventurous side. Even if he did, I figured, why would he mind?
Had my boyfriend known I was taking Ambien during his visits, though, I’m fairly sure he would have minded. It was something I did surreptitiously, in the bathroom with the water running so that he wouldn’t hear the click of the pills as I shook them out into my hand. I liked the drowsy feeling they gave me, which took away any anxiety about being intimate with him after a long separation. Once in a while he would get suspicious and say, “OK, you’re being weird — did you take Ambien?” But I’d act indignant and deny it. Then in the morning my boyfriend would say, “Crazy night …” and I wouldn’t remember a thing that we’d done. Had there been over-the-top dirty talk? Boundary-pushing sexual acts? I didn’t know. The details were lost to me forever, and as I lay there racking my brain, I felt terrified by the yawning absence of memory — and the knowledge that that very evening, I would take Ambien again.
No doubt I was exacerbating my behavior by mixing Ambien with alcohol, one of the things the manufacturer expressly tells you not to do. Combined, they can depress the nervous system to a dangerous — even fatal — degree. But I ignored that warning from the start, telling myself I was working hard and “needed” to blow off steam with a couple of drinks at night. I got so used to mixing the two, I didn’t worry about it. Every so often I would wash down a pill with a sip of red wine.
Eventually my boyfriend and I broke up. I missed him terribly and got support from friends, who suggested I try yoga, meditation and baths with candles. I’ve never been one to sit in a bath — I'm too type A — but one night I was feeling so sad, I decided to try it. I lit some candles, grabbed a glass of red wine and got into the water. It was close to bedtime, so I popped an Ambien, too. Fifteen minutes later, I felt a familiar, melting sensation in my limbs. The lump in my throat dissolved, the sadness and anxiety lifted. I closed my eyes, sank into the tub and allowed myself to feel good for a change. If I could just get through the next few weeks ...
I woke up with a jolt, squinting into daylight; I was freezing, shivering. I had no idea where I was. When I looked down, I saw I was naked and surrounded by low-burning candles. Slowly it dawned on me that I’d been lying in cold water, deeply asleep, for more than six hours. What if I’d drowned? I jumped up, grabbed a towel and blew out the candles. I vowed never to do something so idiotic again. Of course, I made this vow only to myself — I didn’t tell a single friend or family member what had happened. I didn’t even tell my therapist. I figured, I know what I did wrong, so why make people worry?
A week later, still feeling down, I drew another bath, and woke again at 6 A.M. with the candles blazing away. Again I kept my shocking lapse a secret — I just promised myself that this time, I really, really, really wouldn’t do it again. If this logic seems absolutely insane to you, that’s because it is — this is the kind of rationalization that goes on in the mind of an addict. (Months later, when I finally told my therapist the entire story, she asked me if I might have been suicidal. If that was indeed the case, it was a subconscious wish — I wanted to check out from my feelings, not life itself.)
Shortly after the night of the Glamour dinner, I received an e-mail from a friend. She’d written, “How are you?” Something about the simplicity of her note — maybe it was the fact that I was so not OK — moved me to act: I found myself crying hysterically at my desk, pounding out a reply. I was terrible, I wrote. I was addicted to Ambien. I’d nearly killed myself accidentally on more than one occasion. My friend wrote back immediately, clearly alarmed. “You need help now,” she wrote. “Have you ever considered in-patient treatment?” I hadn’t — rehab seemed so extreme. In the flurry of e-mails that followed, my friend pointed out that nearly drowning in a bathtub was pretty extreme too. So was almost burning down my house. So was sex I couldn’t remember. “Get help,” she insisted. I was terrified but decided to go. It had become clear to me that there was no way I could get off the drug by myself. On the plane ride there, I took my last two sleeping pills, having been warned that treatment would start immediately upon entering rehab.
In treatment I was surprised to find I wasn’t the only Ambien addict, not by a long shot: Some people mixed it with something more insidious — cocaine, meth or, like me, alcohol — but sleeping pills were a popular crutch. That first week in rehab, I was up for days, staggering through activities. And I can promise you that had I been home — sleepless and miserable — I definitely would have taken Ambien again. Since that wasn’t an option, I attended lots of group therapy, read recovery literature and stuck to the rehab center’s boot camp-like routine. I learned about the concept of cross-addiction — when you give up one dependency, another can take its place — and decided I needed to quit drinking, too.
A week into my stay in rehab, I had my first great night’s sleep without drugs. I remember opening my eyes at 6:15 A.M. and thinking, Wow, I slept for eight hours; I feel incredible. After that night I had no trouble falling asleep. Two months later when I emerged, I put all I’d learned there to the test in my daily life: I went to bed at the same time every night. I did yoga five times a week. I attended 12-step meetings. I took a year off from dating, to give myself a break. I learned to meditate (on the subway!) and pray. Most important, I didn’t take Ambien or drink in any situation, even when, out of the blue, I found myself up one teeth-gritting night with insomnia.
If the choices I made seem extreme, they were — but then again, so was my addiction. (Plenty of women do just fine on sleep aids; see the box at right for some guidelines.) It’s been more than a year now since I’ve put a drink or a pill into my body. The depression and anxiety I used to suffer from are gone. Most nights I sleep beautifully. Sure, I still have occasional bouts of tossing and turning over some work deadline or a disagreement with a friend — but I no longer leap out of bed to “take care of it” with medication. Instead I gently remind myself that when my body is ready, it’ll sleep.
I wish I could tell you I’ve discovered a miracle cure for insomnia — I haven’t. I’ve made so many lifestyle changes over the past year, I couldn’t say which ones have helped me the most. All I know is I am so grateful for my ability to fall asleep and stay asleep, I’m not willing to experiment with the formula. Life is too good: I am single and OK with it. I’m working steadily on a book. I’m excited about the future. And I can dream again.
Laurie Sandell lives in New York City.
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