The People's Perspective on Medicine

Beware Zolpidem Zombies on Airplanes

We all seek a good night's sleep. Commercials for prescription sleeping pills make them seem very appealing. There's no mention of zolpidem zombies, though.

One of the most popular prescription sleeping pills in the pharmacy is zolpidem (Ambien). At last count, over 19 million prescriptions were dispensed annually. Despite its popularity, zolpidem remains highly controversial. On April 30, 2019 the FDA warned about “sleep behaviors, including sleepwalking, sleep driving, and engaging in other activities while not fully awake. These complex sleep behaviors have also resulted in deaths.” In other words, some people turned into zolpidem zombies. That’s what happened to this reader.

Flight Attendants Call Them Zolpidem Zombies:

Q. When my daughter-in-law died, I was too distressed to sleep and my doctor prescribed Ambien. Then I went to visit my daughter and accidentally took an Ambien before I left home. Once I got to the airport, I kind of went to sleep.

Somehow or other, I got into the parking lot, boarded a shuttle bus and even got to the right gate. Luckily, I had the shuttle ticket in my pocket to help me figure out where I had parked.

I realized on the plane that something was wrong. When I arrived, my daughter took me to the ER to be checked out. Later I figured out that the problem was flying under the influence of Ambien. I’ll never do that again!

A. Zolpidem (Ambien) is a popular sleeping pill. Many people take it on long flights to help them sleep, but sometimes it can cause amnesia. Flight attendants are aware of a phenomenon they term “zolpidem zombies:” people who are sleep-walking or doing other things on an airplane while not fully awake. This has led to some embarrassing situations.

Sleep Walking, Sleep Driving, Sleep Sex!

In its April 30, 2019 warning the FDA offered the following:

“Serious injuries and death from complex sleep behaviors have occurred in patients with and without a history of such behaviors, even at the lowest recommended doses, and the behaviors can occur after just one dose.

“Patients should stop taking your insomnia medicine and contact your health care professional right away if you experience a complex sleep behavior where you engage in activities while you are not fully awake or if you do not remember activities you have done while taking the medicine.

“We identified 66 cases of complex sleep behaviors occurring with these medicines over the past 26 years that resulted in serious injuries, including death. This number includes only reports submitted to FDA* or those found in the medical literature, so there may be additional cases about which we are unaware. These cases included accidental overdoses, falls, burns, near drowning, exposure to extreme cold temperatures leading to loss of limb, carbon monoxide poisoning, drowning, hypothermia, motor vehicle collisions with the patient driving, and self-injuries such as gunshot wounds and apparent suicide attempts. Patients usually did not remember these events.”

*The cases were reported to the FDA Adverse Event Reporting System (FAERS).

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Sexsomnia:

The FDA did not mention sleep sex in its list of cases, but we have heard about this from readers. There’s even a name for this phenomenon: “sexsomnia” (Canadian Journal of Psychiatry, June, 2003).  It is listed as a potential adverse reaction associated with zolpidem (Australian Prescriber, Dec. 1, 2008). 

Zolpidem Zombies: Stories from Readers:

K.D. fell and broke her wrist and toe:

“I have been taking zolpidem for about 10 years. I just cannot sleep if I don’t take it. I have been sleep-eating. My boyfriend found me in the back yard in my nightgown, not making any sense. I fell and broke my wrist and toe (it still looks horrible).

“I sent emails out to EVERYONE in my email address book that said “Mild, blue tarantula (dot) com”–I have NO idea what that means. Now I unplug my landline pc at night–my sisters were really frightened by the email. I also sent one that was just letters, jibberish.

“I asked my doctor how to get off of it and, the one I go to now, says it’s “almost impossible” and that he doesn’t like using it at all…another guinea pig who will be going into retirement years miserable. Thanks, Big Pharma”

This reader reports problems with generic zolpidem ER:

“I have been on Ambien CR for seven years now. It’s worked well for a long time. Recently my pill was changed to generic zolpidem ER. These pills take way too long to put me to sleep. Now I’m up at night eating candy. When I wake up the next morning my wife describes behavior that’s definitely not me!”

Elle became one of the zolpidem zombies:

“My psychiatrist prescribed zolpidem as an aid to eliminate depression-induced insomnia. Within a few short months, I experienced a night-eating episode.

“One morning I woke up out on my back porch (I had gone to sleep in my second floor bedroom) and my mouth was filled with blue-black bits which I first thought to be cockroaches. I had no idea how I had gotten out on the porch. When I went in the house to look in the mirror to see what was in my mouth, I saw the blue tortilla corn chips strewn about. I blamed my cat, Winston, who loved them, until I saw them in my own mouth in the mirror.

“I was horrified, having not one shred of a memory of even awakening in the night. I later found the bag stashed in the refrigerator. (I usually keep them in the pantry.)

“I discussed this at my next appointment. My MD immediately took me off the drug and told me that I was the fourth person in two months that had had a scary nocturnal episode such as mine and that she would no longer be prescribing it as a result. It might not seem scary to simply read this, but to experience the complete loss of control over your behavior and also your memory of the event is frightening indeed.”

Other Ways to Get Some Sleep:

You can learn more about zolpidem and other sleep aids as well as non-drug approaches in our eGuide to Getting a Good Night’s Sleep. This online resource may be accessed at the Guide section of www.PeoplesPharmacy.com.

Share your own sleeping pill story in the comment section.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Tips for beating insomnia: foods to avoid, foods that help, herbal remedies, sleeping pills. Newly revised (November 2016), our online guide (too long to print) includes drugs that may cause insomnia. Learn about the latest medication, Belsomra.

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Citations
  • FDA Drug Safety Communication: "FDA adds Boxed Warning for risk of serious injuries caused by sleepwalking with certain prescription insomnia medicines," (April 30, 2019).
  • Olson, L.G., "Hypnotic hazards: adverse effects of zolpidem and other z-drugs," Australian Prescriber, Dec. 1, 2008, • DOI: 10.18773/austprescr.2008.084
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My daughter woke up at work one day. She had gotten ready for work, drove 30 miles in heavy traffic, parked and walked to her office while sleeping. Her biggest problem was to find her car after work. She of course did not remember where it was parked. She never took Ambien again.

I have been taking zolpidem for 15 to 20 years 5 mg as needed. It helps me get to sleep although not completely through the night. In the horror stories that I read about with people sleep-driving, walking, eating, I never see mention of dosage or other medications (alcohol?) they may be taking. Comment please. Thank you

I had a strange episode after taking the third Ambien pill. I prefer not to describe it as it’s not the point. Happily, I was able to find a natural sleep aid that worked for me quickly and it is simply 3 mg of sublingual melatonin. I was reluctant to try it as melatonin pills had never worked for me, even though I tried taking up to 10 mg at a time.

Re Ambien. I was taking it, too — not every night, however. Then I realized it was on the list for brain problems and quit taking it forever.

My sleeping pill story: over 25 years ago, I needed to go on a long car trip by myself. I was over 50 at the time. I had not been sleeping for years at that point, which problem started when I was in perimenopause. My “holistic“ MD prescribed lorazepam aka Ativan. He did not tell me, nor did any pharmacist, that this drug is highly addictive in that many people develop a tolerance to it almost right away.
I have tried to cut it down and possibly stop at multiple times without success. So, I will be on this drug for the rest of my life and I am now 79. I’m sure it’s doing almost nothing to help me sleep, because I refuse to keep increasing the dose . Sleeping is so important and mine has been so lousy for so long that I am very sure lack of REM sleep is at the core of my many other Physical problems. This is a cautionary tale. If a person takes this drug for sleep, it should be very very temporary.

OMG! People that is so scary. Thank you for your comments about this drug.

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