Is Ambien a Benzo? Understanding Zolpidem as a Sleep Aid

What you will learn

• Ambien (zolpidem) is not a benzodiazepine. It’s a non-benzodiazepine Z-drug that targets sleep problems.
• Ambien works quickly to induce sleep, but it’s only intended for short-term use because of the risks of addiction and other risks.
• It’s important to discuss sleep medications with your doctor, especially if you have a history of substance abuse, take other prescriptions, or have certain health conditions.

If you struggle with insomnia, you may have talked to your doctor about medications that can offer relief. Prescription sleep aids, such as Ambien (zolpidem), can help individuals with insomnia fall asleep and stay asleep longer, promoting restful and restorative sleep.

However, Ambien isn’t the only sleep aid on the market. Other types of drugs can be prescribed for sleep problems, such as benzodiazepines, but they are completely different drugs with different effects and risks. Understanding Ambien’s drug classification, mechanism of action, and potential side effects is crucial for selecting the most suitable sleep medication options.

What Is Ambien and Is It A Benzo?

The common Ambien benzodiazepine classification is a misnomer. Ambien, the brand name for zolpidem, belongs to a class of medications known as non-benzodiazepine sedative-hypnotics. It may also be referred to as a miscellaneous sedative-hypnotic, or a Z-drug. Other Z-drugs include Sonata (zaleplon) and Lunesta (eszopiclone).

Not only is Ambien specifically in a class of non-benzodiazepines, but the Z-drugs were developed as an alternative to benzodiazepines for treating insomnia.[1] Though it was believed to have a lower risk of medication effects and dependence, real-world use has shown that there are still risks with Ambien.

Ambien is typically prescribed when non-drug approaches haven’t been effective, and just for a few weeks at a time. Its mechanism of action allows the drug to target sleep without affecting muscle tension or anxiety like benzos. Ambien is available in immediate-release (IR) and extended-release (ER) formulations. The latter has one layer that dissolves quickly to initiate sleep, while the second layer dissolves slowly to maintain sleep through the night.[2]

How Does Ambien Work As A Sleep Aid?

Both Z-drugs, like Ambien and benzodiazepines, work on the gamma-aminobutyric acid (GABA) system in the brain.[3] However, Ambien is selective and binds primarily to GABA-A receptors containing the alpha-1 subunit, which influence sleep regulation without significant anti-anxiety, anticonvulsant, or muscle relaxant effects.[4] It’s usually prescribed for the short-term treatment of insomnia.

Benzodiazepines bind more broadly to GABA receptors, affecting a wider range of neurological functions. This is why benzos like Valium (diazepam), Xanax (alprazolam), and Ativan (lorazepam) can be prescribed for anxiety, seizures, and muscle relaxation. At the same time, Ambien is almost exclusively used for insomnia and sleep problems.

Ambien also has a relatively short half-life of about 2 hours.[5] This allows the drug to help you fall asleep without lingering sedation and a “hangover” feeling the next day. Benzos vary in half-life, with some lasting significantly longer, so they’re more likely to cause daytime drowsiness.

Effects and Potential Side Effects of Ambien

Ambien helps with insomnia quickly, often within 15 to 30 minutes.[6] Its effects last about 6 to 8 hours, making it effective for inducing sleep and allowing you to get some rest without waking up groggy the next morning. Though some people report a next-day hangover, it’s usually mild.

Despite its benefits, Ambien can cause a range of side effects like:[7]

• Headache
• Nausea
• Diarrhea
• Drowsiness
• Dizziness
• Cognitive impairment, such as poor coordination, memory, and attention
• Complex sleep behaviors like sleepwalking or sleep driving

Ambien is generally well tolerated, but some groups are at a greater risk for side effects. Women metabolize Ambien more slowly than men, so lower initial doses are recommended to monitor side effects.[8] Older adults can be more sensitive to the sedative effects, increasing the risk of falls, confusion, and possible injuries.[9]

Initially, Ambien was thought to have a lower risk of dependence. More and more evidence indicates that long-term or high-dose use of Ambien can lead to physical dependence and withdrawal symptoms like mood changes, restlessness, and anxiety.[10] Insomnia tends to rebound much worse than before during Ambien withdrawal.

How to Discuss Your Options with Your Doctor

If you struggle with insomnia and feel like you need a sleep aid, you should talk to your doctor about the benefits, risks, and alternatives. Ambien isn’t often used as a first-line treatment for chronic insomnia.[11] Lifestyle changes, such as sleep hygiene, and therapy like cognitive behavioral therapy for insomnia (CBT-I) are tried first.[12]

Because of the risk of dependence and addiction, Ambien is only intended for short-term use, generally no longer than 2 to 6 weeks. Long-term use can build tolerance, so you need higher doses for the same effect, and then dependence and withdrawal can occur.

Make sure you disclose any history of substance abuse, liver or kidney problems, depression or anxiety, respiratory issues, or use of alcohol and other sedatives to your doctor to help them determine if Ambien is safe for you. As a sedative, Ambien should not be combined with central nervous system (CNS) depressants like alcohol, opioids, or benzos because of an increased risk of dangerous sedation, respiratory depression, and overdose.

Although Ambien is considered less addictive than benzodiazepines or other depressant drugs, there’s still potential for addiction. Ambien is classified as a Schedule IV controlled substance because it risks abuse and dependence.[13]

Alternatives to Sleep Aids

While medications like Ambien can be helpful for short-term relief, long-term management of insomnia with behavioral and lifestyle changes can be effective. These non-medication approaches avoid the risk of side effects and dependence while addressing the underlying causes of sleep problems.

• Work on sleep hygiene. Ensure you maintain a healthy sleep schedule and establish a consistent bedtime routine to help unwind and prepare for sleep.
• Limit caffeine, alcohol, large meals, and vigorous exercise right before bed, which can affect your ability to fall asleep.
• Keep your bedroom cool, dark, and quiet before bed. You should only use your bed for sleep and intimacy, not for work or screen time.
• Try relaxation techniques, such as yoga or meditation, to calm your mind and combat stress before bed.
• Consider therapy techniques like CBT-I to combat chronic insomnia and change the patterns and behaviors that interfere with restful sleep.

Is Ambien Right for You? Sleep-Aid Considerations

Ambien is not a benzodiazepine, but it does act on the same GABA neurotransmitter system to induce sleep and provide short-term relief for people struggling with insomnia, especially trouble falling asleep. Ambien is not without risks, however, and should only be considered with careful monitoring.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more