The Ambien trials, part 1

What does one do with oneself between diagnosis of obstructive sleep apnea and treatment? My appointment with a dentist just to start the process of getting an oral appliance is one month away. That will be followed by an adjustment period of how long I don’t know. The oral appliance may fail and then I’d go to a CPAP machine. This could all take a while. I’m thinking it’ll be months until back to anything like normal.

So, I have a lot of time to tinker with myself.

My preference is to go unconscious for the duration, but I’d settle for 7-8 hours at night. What I mean by this is that though I can’t stop the apnea events without treatment, I might be able to keep them at a subconscious level, which is better than nothing. In fact, I suspect this is how I’ve been living for months, if not years. I very much doubt that my awareness of apnea events starting in December was the first time they occurred.

Maintaining unconsciousness is hard for a recovering insomniac whose sleep is disrupted multiple times per hour. I can usually do it for the first 3-4 hours of the night. The trouble begins around 1-2AM and can last several hours. At worst, I’m up for the day. This is to be avoided!

Small doses of Benadryl (Diphenhydramine*) can work for me, usually. I didn’t know I was treating OSA this way. I thought it was just dealing with occasional, short-term insomnia spikes. (PSA: Long-term, insomnia not associated with another problem, like OSA, is best treated with cognitive behavioral therapy.) By small doses I mean 1/4 of one pill (6.25mg). A full dose is two pills (50mg).

I told my primary care doc this yesterday and she suggested I give Ambien (Zolpidem*) a try. So, now I’m tinkering with that. But, how to use it?

My first trial was last night. Being risk averse, I tried a half a pill (5mg) at bedtime. That knocked me unconscious until 2:15AM. I suspect apnea events woke me, and they certainly kept me awake thereafter.

So, the first trial failed. What’s next?

My choices are (a) take the full, 10mg pill at bedtime or (b) take a half pill (5mg) when I wake around 1-2AM. The first of these would be the “normal” way to take the drug. It’s as directed. But would it sustain through my trouble spot?

The second of these would seem to target my problem very precisely. I bet it would work in the sense of helping me sleep in the wee hours, but maybe I’d have trouble waking in the morning. That could be a risk worth taking, since I typically don’t have to get up at any particular hour.

I have 9.5 more pills in the bottle, so I can try both of these, as well as a few other variations, if I think of any.

* Approximately nobody knows these things by generic names, so I am not going to use them exclusively, if at all. Yeah, that’s giving in to the brand manufacturer. Sue me.



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