Insomnia is a sleep disorder that can make it difficult for a person to fall asleep, remain asleep, or both. Generally, insomnia can be categorized as either acute or chronic. Acute insomnia lasts for between one night and two weeks, while chronic insomnia lasts for three weeks or more. Even when a person allows themselves enough time to fall asleep and get several consecutive hours of rest, the condition prevents them from resting. This can impair cognitive function and motor coordination the next day due to exhaustion.
Because insomnia can be debilitating, medical professionals and researchers have worked hard to find remedies so their patients can get the rest they need. Several prescription medications now exist that can help a person fall and stay asleep. Two of the most popular prescription medications used to treat insomnia are ProSom and Ambien.
ProSom vs. Ambien
Although both ProSom and Ambien are widely prescribed to treat insomnia, they are different classes of medications. ProSom is a benzodiazepine, while Ambien is a nonbenzodiazepine sedative.
ProSom is the brand name for a benzodiazepine, estazolam, that is used to treat insomnia for 10 days or less. Short-term treatment is important with all benzodiazepines, since the body can quickly build up a tolerance to, and dependence on, these medications. ProSom also does not help increase deep sleep, so people who take benzodiazepine insomnia medications can end up not feeling rested, even when sleeping through the night. Side effects of taking ProSom can include:
- Daytime drowsiness
- Inability to concentrate
- Decreased reflexes or impaired coordination
- Dissociation or feeling “spacey”
As the body begins to tolerate the prescription dose of ProSom, however, these side effects will begin to go away. After 10 days, if insomnia persists without the help of ProSom to sleep, then the doctor and patient should consider underlying conditions that are causing the insomnia and treat those instead.
Medications like Ambien, which is the brand name for a nonbenzodiazepine sedative zolpidem, were developed in reaction to the potential for people to become addicted to benzodiazepines. Although Ambien acts similarly to ProSom and other benzodiazepine insomnia medications, this drug is classified as an imidazopyridine. Ambien also does increase deep sleep, which can help the person feel more rested after a few days. Ambien’s side effects include:
- Feeling groggy or sleepy the next day
- Parasomnia, performing activities while asleep
Like ProSom, Ambien should only be taken for 10 days or less. There is a potential for addiction to Ambien after a month of use, although there is a lower risk of developing a tolerance to Ambien and similar sleep aids.
Although Ambien and ProSom are in two different classes of medicines, they both act on the same receptors: GABA receptors. The medications bind to GABA receptors and inhibit the uptake of neurotransmitters that stimulate rapid firing of neurons. This creates a sense of relaxation, which, in the case of both medications, allows the individual taking them to go to sleep. This action can, however, induce euphoria, or a “high,” which can be addictive for some people.
How Are ProSom and Ambien Prescribed, and How Are They Abused?
Ambien and other nonbenzodiazepine medications were developed, in large part, to replace ProSom and similar benzodiazepines. They both treat similar types of insomnia, and they are both designed to work for only a short period of time. There is some indication that ProSom is a better choice for people who have an anxiety condition that may be causing insomnia, while Ambien is a better prescription for people who have no underlying psychiatric condition. However, because both have a potential for abuse and addiction, people who have struggled with addiction in the past should discuss that with their doctor before taking either of these medications. Some people who struggle with insomnia do not find Ambien strong enough to make them go to sleep, so they may benefit from switching to a benzodiazepine like ProSom.
Because both Ambien and ProSom have similar effects on GABA receptors, they can induce central nervous system (CNS) depression that is similar to other addictive substances, particularly alcohol. People who have prescriptions for either ProSom or Ambien are warned by the Food and Drug Administration (FDA) labels not to drink alcohol and take these medications at the same time, even if the alcohol consumption took place earlier in the day. When a person becomes addicted to either medication, it is recommended that they work with a doctor to taper off the medication until their body is no longer physically dependent on it. This could be useful when reducing a legitimate prescription dose too.
What Happens When ProSom and Ambien Are Combined?
People who take prescription CNS depressants, regardless of the reason, should be very careful about mixing these medications together. Both Ambien and ProSom are considered CNS depressants, as are opioid drugs, barbiturates, and alcohol. CNS depressants can enhance each other’s effects, which can more rapidly lead to overdose. Notes on Ambien’s drug interactions show that estazolam, or ProSom, is not recommended to be taken at the same time as Ambien, due to potential dangerous consequences.
Xanax is another common benzodiazepine medication, although it is used to treat anxiety and not insomnia. However, an article in AARP notes that it is dangerous to mix benzodiazepines like Xanax with Ambien, as the side effects can become more serious, increasing the risk of falls, amnesia, and cognitive impairment, and slowing breathing to a dangerous level. This suggests that mixing ProSom and Ambien could potentially cause a person to stop breathing.
- Respiratory depression, or reduced or irregular breathing
- Stupor or somnolence
- Slurred speech
- Loss of coordination
- Changes in heart rate and blood pressure
Although there are chemical differences between Ambien and ProSom, these two medications are prescribed to treat insomnia in similar ways, for a similar length of time. Both of these medications have a potential for abuse, dependence, and tolerance as well, so it is important to take them only as prescribed. People who have struggled with substance abuse in the past should speak with their doctor if they receive a prescription for these substances, as a history of substance abuse increases the chances of becoming addicted to either ProSom or Ambien.