Sleep Medications (Zolpidem, Ambien)
Common brand names: Ambien, Ambien CR, Lunesta, Sonata, Belsomra
Three nutrients listed against this medication. The most severe is marked mild.
At a glance
None of the three is marked well documented. Each row carries its own evidence level.
At a glance
- MelatoninMild · Traditionally cited, limited evidence
- MagnesiumMild · Traditionally cited, limited evidence
- Thiamine (Vitamin B1)Mild · Traditionally cited, limited evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Zolpidem and other GABA-A agonists induce sleep without engaging the circadian melatonin system, which is the basis of the suggestion that they leave endogenous rhythm untrained. Suppression of melatonin secretion by these drugs has not been demonstrated in humans, and the dependency associated with them is pharmacological rather than melatonin-mediated.
Common signs, Melatonin system downregulation, rebound insomnia on discontinuation, daytime grogginess
Lemoine et al. (J Sleep Res, 2007; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 18036082): prolonged-release melatonin improved sleep quality and morning alertness in insomnia patients aged 55 and over. Melatonin is the intervention in that trial, not the casualty: Z-drugs and benzodiazepines have not been shown to deplete melatonin.
Melatonin 0.5–3 mg 30 minutes before bed is a range in common use. Lemoine tested prolonged-release melatonin in insomnia in adults 55 and over, not as a substitute during sleep-aid discontinuation.
Mechanism, Magnesium acts on GABA signalling, the same broad target as many prescription sleep aids, and magnesium has been studied as a treatment for insomnia. What was measured there is magnesium affecting sleep, not sleep aids affecting magnesium. Sleep aids have not been shown to deplete magnesium.
Common signs, Underlying insomnia continues, anxiety, muscle tension, restless leg syndrome
Magnesium supplementation may improve insomnia (Abbasi, 2012, augmentation); sleep aids are not shown to deplete magnesium.
Magnesium 400 mg 30–60 minutes before bed is a figure in common use, not from a trial cited on this row. No cited trial tested magnesium in people discontinuing a sleep aid.
Mechanism, Long-term GABA-A agonists impair thiamine-dependent neuronal metabolism, contributing to cognitive side effects associated with prolonged use.
Common signs, Cognitive impairment with long-term use, memory issues, peripheral neuropathy
Billioti de Gage et al. (BMJ, 2014; PMID 25208536): benzodiazepine use was associated with higher risk of Alzheimer's disease in a case-control study. That is a dementia-risk association, not thiamine depletion. The thiamine link is speculative.
Benfotiamine 150–300 mg daily is a figure in common use, not from a trial cited on this row. The row's own evidence states the thiamine link is speculative, and the cited paper concerns benzodiazepines and dementia risk.
For your next appointment
It prints or saves as a single page. Whether to add a supplement for a nutrient this medication may lower is a decision for your prescriber.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →