Just over a month ago, a young man found himself in an uncomfortable sleeping arrangement. After a night out with a group of friends-dinner on the Lower East Side, drinks at Soho House-he found himself alone in the home of a senior editor at a well-known fashion magazine. This didn’t seem like a bad thing: The woman was in her early 30’s, attractive and, according to the young man, angling for some action. But then she said something-something which he later described to friends as “the most disgusting thing I’ve ever heard.”
“She was laying there,” he said, “and had taken her clothes off. Then, in completely slurred speech, she said: ‘I just took two Ambien, so anything you’re going to do, you better do it before I pass out.’ She said she hadn’t slept a night in seven years without her Ambien.”
The young man had come face to face with a member of the Ambien Generation, where being turned on takes a back seat to being able to turn off. In this edgy, post-9/11 city, sleep is more and more seen as an inalienable right: Tossing and turning is for suckers. Though Ambien, the country’s best-selling insomnia medication, has been on the market since 1993, it’s increasingly begun to occupy the same place in many New Yorkers’ lives as coffee and cigarettes. And if Viagra was the boutique drug of the 90’s, now New Yorkers are pining for a drug that renders them useless at bedtime. The city that never sleeps is becoming the city that can’t wait to go to sleep.
Ambien seems to have dodged any social stigma. During the trial involving Vogue editor Anna Wintour and her former nanny last October, the disgruntled ex-help claimed that Ambien was Ms. Wintour’s prescription drug of choice. Back in October 2003, then–Secretary of State Colin Powell boasted to a Saudi reporter from the London-based Asharq Al-Awsat: “They’re a wonderful medication-not medication. How would you call it? They’re called Ambien, which is very good. You don’t use Ambien? Everybody here uses Ambien.” Actress Scarlett Johannson told InStyle what her cure for jet lag was: “Drink
“I get more bang for an hour of sleep with Ambien than I can without it,” said a venture capitalist who spoke on the condition of anonymity. “But the first few times you take it, you’ve got to be careful. Make sure you’re in bed, because literally within five minutes of taking it, you’ll literally pass out wherever you are.”
Liz Withers, a 28-year-old self-employed entrepreneur who lives on the Upper East Side, estimates that she’s taken Ambien 100 times. “It gives me the best night’s sleep of my life,” she said. “I take it when I’m stressed out from work, can’t sleep, have a lot on my mind. I take that and I sleep like a baby. You just drift off into a nice sleep, and when you wake up in the morning, you’re not groggy. It’s fabulous-I couldn’t live without it …. I don’t forget things the next day …. I take it on a regular basis.”
Daytime use of Ambien is not unheard of. “I have a number of clients who, the only way they get through the mediation or counseling sessions with their husbands is Ambien,” said a Manhattan divorce lawyer. “They knock themselves out and then they’re on automatic for the 45 minutes. Whatever the virtues may be for patients, it’s great for the company that manufactures it.”
Last year, nationwide sales for Ambien reached $1.88 billion. With its seductive name-think ambient noise, a pleasant ambiance, good morning (a.m. = “morning,” bien = “good”)-Ambien would seem to have a hold on the market. But wait: Sepracor’s Lunesta, which was launched this month with a $60 million ad campaign, promises longer, uninterrupted sleep, and it doesn’t carry Ambien’s warning that one should only take it for seven to 10 days. Meanwhile, Sanofi-Aventis, the makers of Ambien, are awaiting F.D.A. approval for a newer version of Ambien that can induce longer sleep periods.
At a recent party, actress Helen Hunt’s boyfriend, novelist Matthew Carnahan, remembered his Ambien-induced sleep: “You have strange dreams. If you try to stay awake, you make phone calls you don’t remember-it’s like living a horrible blackout.”
At the same party, Eric Gilliland, a TV writer, said, “Ambien saved my life at first, but later I abused it. I crossed eight different time zones in five days and overdid it. Now I take a third of a pill and that’s enough.”
“I never have insomnia except the second night in Europe, and then I take one melatonin. But I never have insomnia,” said author Erica Jong. “I can sleep almost anywhere-on a plane, on a train. I’m a sleeper. I could sleep 14 hours a night and be happy. I don’t need Ambien. I mean, talk to me about Effexor, the antidepressant: I like that.”
“It’s not like it was ever prescribed to me,” said a 28-year-old who works in publishing and began taking Ambien during the stress of her upcoming wedding. “A lot of my friends were taking it and gave me some, and it’s actually the perfect thing for those nights when you’re up late and working, because you don’t need to worry about winding down. It just gets you to sleep. It knocks you out.”
Not everyone is a fan. At a recent book party in Manhattan, the singer Judy Collins said she’d taken Ambien once. “Once is more than enough,” she said. “I would never go near it. It’s a horrible, horrible drug. I had people coming in from the walls. I had a shoulder replacement seven years ago-it was a major, major surgery, a big, big deal …. I took this pill, I’m telling you, people were coming out of the walls. Crazy-are you kidding? Insane, scared, terrified. Aliens for sure. I think one of the problems in this country is too many people are on either or both Ambien and Viagra. I mean, give me a break! Ambien is dangerous, inducing-from my point of view-psychotic states. If you’ve had those experiences before, you want to stay away from it. You know what? Lack of sleep will not kill you. Of course I have a sleepless night every once in a while-everybody does. I get up and work. You know what helps me? A little apple juice. There are many remedies to go to sleep. One thing is to lay there and pray for peace-that’s not a bad idea.”
Ambien is in a class of drugs known as hypnotics. When Jacqueline Susann wrote Valley of the Dolls in the mid-60’s, she referred to sleeping pills as being among the little “dolls” that kept Neely, Jennifer and Anne zoned out as they lived their glamorous postwar life in the city. Though for Neely, the dolls stopped working: “[S]he went to her bedroom, pulled the blinds … and swallowed five red pills. Five red ones hardly did anything now. Last night she had only slept three hours with five red ones and two yellows.”
Ambien works by increasing the effects of a neurotransmitter called GABA that promotes sleep. The drug targets a specific group of GABA receptors as opposed to a broader range, and hence, unlike older sleep meds, reduces side effects such as grogginess, memory loss, hallucinations and clumsiness. But Ambien is still considered habit-forming. The Drug Enforcement Administration classifies it as a Schedule IV narcotic, meaning it’s a controlled substance with potential for abuse.
The venture capitalist said he’s been taking Ambien every night for a year and a half. “After a while it becomes much less overwhelming, but you do get the GABA high for about 20 minutes before you sleep,” he said. He was first prescribed Ambien after suffering a week of insomnia during a business trip. “I live a really crazy life,” he said. “I’m on a plane a lot. I have seven different deals going on at one time. It’s intense-there’s never a slack moment.”
When told that people were using Ambien for longer than the prescribed time, Melissa Feltmann, a spokeswoman for Sanofi-Aventis, insisted that Ambien was safe to use for a period of 30 days. “The label on the medication’s bottle that they should be limited to seven to 10 days refers to hypnotics in general,” she said. “Ambien is actually indicated for the short-term treatment of insomnia for a 30-day supply.” She added, “If people go beyond the prescribed time, a physician and patient make decisions about their treatment.”
According to a 2005 poll by the National Sleep Foundation, in the Northeastern U.S., 18 percent of respondents were getting less than six hours of sleep a night. But is popping a pill the answer?
“People can’t turn their brains on and off like we can a light switch,” said Dr. Daniel Salzman, a sleep specialist at the New York Presbyterian Sleep/Wake Disorders Center in White Plains. “We live in a society-especially New York-where we are overstimulated. To be able to do something doesn’t mean we should be. We weren’t built for a 24-hour society.”
He added, “By altering the circadian rhythm, your natural sleep mechanism, you’re definitely taking a toll on your health.”
Dr. Salzman advocates behavioral techniques for treating the sleep-deprived and cautions against overuse of Ambien. “It’s potentially problematic that people take it over two weeks,” he said. “While you’re giving someone the Ambien and you’re treating the symptom, they’re able to sleep fine. When they stop, the underlying cause is still there. Many people may develop a psychological dependence on the Ambien-or on any sleeping pill, for that matter. They eventually begin to believe they can’t sleep without it.”
“In general, people who have problems with alcohol are prone to have problems with benzos or Ambien,” said Dr. Edward Kenny, a prominent psychopharmacologist with a practice on the Upper West Side. “People who use too much Ambien use it to cope with their life.”
As for potential dangers, Dr. Kenny added, “One of the things which has not been studied is, it can cause some subtle memory change. Nobody’s been studying Ambien’s long-term effects. With benzos, the hippocampus can shrink.”
“We don’t know what harmful effects it may have, but Ambien is an addictive drug that tends to habituate,” said Dr. Daniel Kripke, one of the few voices in the medical profession whose Web site, www.darksideofsleepingpills.com, warns of the dangers of prescription sleeping meds. “It may take 10 to 20 years to know what the effects of the drug will be. It’s like how the tobacco industry was before it was regulated.”
Not surprisingly, some of the city’s late-night party crowd has reportedly been indulging in Ambien. The claim is that if one takes three or four Ambien and then forces oneself to stay awake, hallucinations follow.
Whether one is taking Ambien or not, it has definitely become part of what New Yorkers talk about when they talk about sleep.
“I was put on sleeping pills at age 8 by a psychiatrist,” said writer Daphne Merkin. “Ambien is not my love. I think Ambien works on non-diehard insomniacs. I tried it last night; I took it with a Klonopin. I think insomnia goes to a degree with a constant state of melancholia …. Like I have trouble getting up, I have trouble tuning out. The touted plus of Ambien is that it works quickly and it’s out of you quickly. But I may be too inured. I wouldn’t call myself a junkie, because any junkie tendencies have been beaten out of me from my childhood. I think Ambien is a very good drug; it’s just never worked for me. I have never even tried it in the five-milligram form-I went straight to 10 milligrams and Klonopin, and I was still awake an hour and half later …. Lately I’ve been trying not to take sleeping pills …. Xanax I don’t find great; Klonopin is the new Valium. I was once sent to a shrink who said to me if I hadn’t come from an orthodox Jewish background, I would be a heroin addict, by which I think he meant I wanted to blunt my sensibilities. Basically, on some level I want to conk out …. A certain kind of TV does it for me: Sex and the City. I sort of get cozily involved in what shoes is she going to pull out …. Charlie Rose? No, he agitates me.”
“People, especially in theater, we have a lot of trouble going to sleep,” said actor Adrian Zmed of T.J. Hooker fame. “Our brain-we can’t shut it off. I’ve seen Ambien. I’ve looked at it and I’ve said, Hmmmm. I work in theater, I can’t shut it down until 2, 3 in the morning; the brain just won’t let go. I’ll try anything. I’ve tried everything you can imagine. Sometimes you just stay up until you fall asleep. I use ear plugs-shut out the world-and probably a couple of drinks before I go to sleep and leave it at that.”
“For me, Ambien falls into the category of pragmatic pharmacology,” said Jeremy Walker, of Jeremy Walker and Associates, a movie publicity company. “If you have a headache, take aspirin. You watch Desperate Housewives and you’re all wound up afterward-so I find myself taking half an Ambien on Sunday nights, so you’re entire week isn’t fucked up.
“Originally, the reason I got the prescription was because the year before, at the Sundance Film Festival, I’d experienced sleeplessness due to stress,” he continued. “I asked my doctor for a prescription the following year, and for whatever reason I never used it. Then I noticed the Sunday-evening problem.”
“The funny thing about Ambien is, you know when you get sleepy-naturally sleepy-your eyes get tired, and they get sort of dry and you rub them, and it’s sort of a precursor to sleep,” Mr. Walker added. “I’ve noticed that’s one of the things Ambien does: Your eyes get dry, you rub them and you get slightly cranky, and then you want to go to sleep. And it does it in minutes.”
But there’s a question left hanging: Is it really healthy never to have any dark nights of the soul, those horrid stretches of crepuscular creepiness which often result in inspiration and a humble respect for the mysteries of the human heart?
“Ambien is relatively effective in the short term, but you really got to find the underlying cause,” said Dr. Salzman. “Why would people want to take a pill to sleep for the rest of their life?”
-Additional reporting by George Gurley, Rebecca Dana and Raquel Hecker.