8 Ambien (Zolpidem) Side Effects You Should Know About

It’s common to experience insomnia (sleeping difficulties) every now and then. But for some people, it’s a chronic (long-term) issue. Your insomnia is considered chronic if it happens at least 3 nights per week for a minimum of 3 months.

Chronic insomnia can negatively impact your quality of life. And a lack of sleep is also linked to other medical conditions — such as depression, heart disease, and diabetes. If you’re struggling with sleep issues, a prescription medication such as Ambien (zolpidem) may help. Ambien can help treat insomnia, but it’s only meant for short-term use, and has several side effects you should be aware of.

Ambien side effects at a glance

Below are the common and rare Ambien side effects reported in clinical trials. Keep in mind that you may experience side effects other than what’s listed here.

Common Ambien side effects:

• Drowsiness

• Dizziness

• Nausea and vomiting

• Diarrhea

• Feeling groggy during the day

• Memory problems

• Headache

• Double or blurry vision

• Muscle or joint pain

Serious Ambien side effects and risks:

• Allergic reactions

• Withdrawal symptoms (if stopped abruptly)

• Abnormal thinking and behavior

• Increased risk of falls, injuries, and car accidents

• Hallucinations

• Worsening depression

• Sleepwalking or other activities performed while asleep (parasomnias)

• Trouble breathing

• Possible increased risk of dementia in older adults

Let’s take a closer look at eight Ambien side effects you should consider before taking it.

1. Daytime drowsiness

Since it treats insomnia, it makes sense that the most common Ambien side effect is drowsiness. In most cases, drowsiness is a welcome side effect. But sometimes it can last longer than you’d like, and cause you to still feel drowsy the day after taking it. 

It’s best to only take Ambien if you can rest for a full 7 to 8 hours after taking it. And don’t combine it with other substances that can make you drowsy. This includes alcohol, benzodiazepines, or opioid pain medications. And if you’re feeling drowsy the day after taking Ambien, avoid driving until you’re feeling alert enough to do so safely.

Zolpidem ER (Ambien CR) is an extended-release version of Ambien. It lasts longer in the body, and can cause next-day drowsiness in up to 15% of adults who take it. In fact, the FDA warned that you shouldn’t drive or engage in other activities that need mental alertness the day after taking Ambien CR.

If daytime drowsiness is an issue for you while taking zolpidem ER, talk to your prescriber about switching to an immediate-release version. This may help lower the chance of this side effect.

2. Dizziness

Ambien affects your brain and spinal cord, also known as your central nervous system (CNS). This can cause dizziness and make you feel more groggy or clumsy than usual. It can also make falls more likely. And these falls may result in brain injuries and hip fractures in those taking Ambien. This is especially true for adults ages 65 and older. 

It’s best to wait until right before bedtime to take Ambien. This helps lower the chance of falls due to dizziness. If you need to get up after taking Ambien, move slowly and hold on to something to help you move around safely.

3. Nausea

Nausea is another possible Ambien side effect. Dizziness caused by Ambien can lead to nausea. But it can also happen on its own in some people. Nausea also seems more likely with zolpidem ER.

It’s best to take Ambien on an empty stomach. But if nausea is bothersome, taking it with a small snack before bed may help. Just be aware that food can make Ambien less effective and take longer to work. You can also talk to your prescriber to see if a lower dose or a different form of Ambien may be a better or more tolerable option for you.

You may also feel nauseated if you stop Ambien treatment suddenly after taking it for a while. We’ll discuss Ambien withdrawal in more detail later in the article.

4. Sleepwalking and other abnormal sleep-related behaviors

It isn’t common, but Ambien may cause you to sleepwalk or perform other tasks while asleep after taking it. This can include making and eating food, talking on the phone, and online shopping. It can also include more risky actions, such as sexual activity, driving, or even committing a crime. The FDA added a boxed warning (the most serious medication warning) about the risk of injuries caused by sleepwalking while taking Ambien or other medications like it.

You may not remember these actions, which can be scary or even dangerous in some cases. If you or a loved one notices signs of odd sleep-related behavior after you’ve taken Ambien, talk to your healthcare team. A different medication may be a safer option for you.

5. Abnormal thinking and behavior

Other behavior changes can also happen while taking Ambien. Agitation, aggression, and other out-of-character actions are possible. Hallucinations — both seeing and hearing things that aren’t there — can also be an issue. Hallucinations, though, seem more common with zolpidem ER. 

Taking Ambien along with a selective serotonin reuptake inhibitor (SSRI) can also make hallucinations more likely. Popular SSRIs include sertraline (Zoloft) and fluoxetine (Prozac).

If you notice changes in your behavior or start having hallucinations while taking Ambien, reach out to your healthcare team right away. They’ll likely want to change you to a different medication to help you sleep.

6. Ambien withdrawal symptoms

As mentioned, you may experience withdrawal symptoms if you stop taking Ambien suddenly after taking it for a while. This is also possible if you lower your dose too quickly. Symptoms can include nausea, vomiting, and stomach cramps. Sweating, tremors, and seizures can happen in more severe cases.

Ambien withdrawal symptoms can last from several days to a few weeks. But symptoms often start to improve about 4 to 5 days after stopping the medication. Withdrawal symptoms are more likely if you take higher doses of Ambien than prescribed for you. But it can happen at prescribed doses, too.

If you’d like to stop taking Ambien, your prescriber can help you do so safely. They can also give you tips to manage any withdrawal symptoms if they occur.

7. Higher risk of dementia

Older adults have a higher risk of long-term side effects from Ambien. This can include memory impairment and confused thinking in particular. A 2017 study from Taiwan followed almost 7,000 older people taking Ambien over 2 years. It found a greater risk of Alzheimer’s disease in people who took Ambien more than 180 days per year compared to those who took it less than 28 days per year.

Ambien is also associated with a higher risk of dementia in general in older adults. But more information is needed to better understand this risk.

8. Higher risk of cancer and death

Ambien is linked to a higher risk of cancer, death, or both. This higher risk was found with other prescription sleep aids, too. In a 2012 study, the higher risk of death appeared even in people who took fewer than 18 doses of medications like Ambien per year over a 2.5-year time period. 

In another 2012 study, people taking 300 mg of Ambien or more within 1 year were more than six times as likely to have cancer than those not taking it. And a 2022 study found a higher risk of death from brain cancer in people aged 18 to 64 years who were exposed to Ambien.

Keep in mind that just because Ambien is associated with a higher risk of cancer and death doesn’t mean it directly causes them. More information is needed to better understand these potential connections.

Is Ambien safe?

Ambien is considered safe for most people if it’s taken as directed for a short period of time. But it’s not approved for long-term treatment. And it’s not recommended for older adults due to the higher risk of falls and dementia while taking it. 

Ambien is also a controlled substance. This means it carries a risk of dependence or misuse for those who take it. So it may not be a safe choice if you have a history of substance misuse or dependence.

It may also be less safe to take Ambien if you have a history of depression or experience sleep apnea. Ambien can worsen these conditions, so you should only take it with your prescriber’s OK. 

As mentioned, the FDA has warned people about driving after taking Ambien. A 2015 study suggests that you’re roughly twice as likely to get into a car accident if you take Ambien. And that driving while taking Ambien is much like driving while intoxicated with alcohol.

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Written by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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