May 10th, 2011, my life changed forever, in a way I never thought I’d ever have to deal with, and certainly not at the age of 28. My best friend had died suddenly at 31 of what we would eventually come to discover was a massive heart attack. At the time, though, there was some severely conflicting information around the circumstances in which she was found, and the terror that the queer community has had for too long set in over me and my friends. Had she died from violence? Had someone murdered my best friend and big sister?
I quickly worked to contact our friends and start spreading the word. Stacy was dead, and for another time in my life, I was asked to be the strong one for our friends, work to organize a short notice group of us to get together that afternoon and mourn. We couldn’t help the speculation, and that terror grew larger in the absence of facts.
The biggest issue for me was yet to come. There was simply no way I was going to sleep that night, and I’d be likely to end up drinking home alone, which for me is a particularly bad combination. My suicidal tendencies are triggered hard by alcohol and lack of sleep, and in combination they’re a recipe for disaster. I called my friend, referred to as “Doc” for these proceedings as she’s a psychiatrist at my hospital, and her name is too uncommon and could easily be publicly identified.
She knew me and my existing mental health issues all too well, though she wasn’t my treating psychiatrist. Without hesitation, she insisted that I should come and stay the night at her house. They had a comfortable guest bed, plenty of room and privacy, and we could spend time talking.
Upon arriving which was already somewhat late, she gave me a small ziploc bag with an Ambien in it in case I had difficulty getting to sleep. I told her that was almost a guarantee, and so she suggested I take it as soon as I got settled for bed. Settling into the remarkably comfortable bed, I opened my laptop and checked Facebook again, checking in with people one more time for that awful day, and let a few close friends know I was staying with someone for the night and I was safe. I took the Ambien with the rest of my meds, and rolled over to try to sleep.
The next thing I remember, I woke up the next morning and felt… good! The memory hit me almost immediately, but I was clear headed and felt like I hadn’t slept better in years. I knew it wouldn’t last, but for the moment, I was able to go on.
That was my first experience with Ambien, a true trial by fire.
Prior to starting my transition, sleep hadn’t ever been much of an issue for me. I could function like a Marine, sleeping just a couple of hours a night and go that way for weeks on end. When I slept a full night, I’d get up in the morning pretty easily, or if I wanted, just roll back over and sleep some more.
Since starting hormone therapy, I have found it increasingly hard to get a good night’s sleep, and exponentially more difficult to survive on less than ideal sleep levels. Still, I rejected most sleep medications because of the potential side effects and addictions. I have a large family history of addictive personalities, so I always strayed towards caution.
After having the experience with the death of Stacy, however, I knew I had found something that worked. If it could be properly managed for long term use, I would be able to get back to somewhat normal sleep patterns and enable my body to work more to take care of itself. Speaking to my psychiatrist, he first prescribed me trazodone, saying it was preferred to Ambien if it worked.
Unfortunately, trazodone left me remarkably sleepless, and feeling like crap in the morning. Almost immediately, I stopped it and spoke to my doctor again. He remitted and gave me a script for the Ambien.
Since starting Ambien, I have been careful to minimize my use of it as much as possible. While my doctor said that addiction is unlikely if I find no early dependence on it, I was still concerned about building up a resistance to it. To that, he said as long as I use it five or fewer nights a week, I should be fine. Typically, I use it four nights or less, and have had no issues with resistance or lessened effect.
Using it just once, I often find that my sleep schedule is stabilized for the subsequent two nights, if I don’t find myself up late or have some extenuating circumstance. Of course, your mileage may vary. I have a coworker who didn’t stay asleep all night and ended up using Ambien CR, and had to subsequently discontinue using it entirely, as he had heart palpitations from it. Another friend uses the 10 mg formulation while I only use the 5 mg.
As always, if you use Ambien, always follow YOUR doctor’s advice and dosing instructions. If you choose to request Ambien from your doctor, be aware that they may wish to try other medications for you first, as again, everyone will respond differently to different medications, and you may find that one of the other meds suits you as well or better, with fewer potential risks. Report any reactions that concern you to your doctor as soon as possible.