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#38403 - 07/08/14 08:07 AM Ambien or other sleep aids
JoB Offline


Registered: 07/08/14
Posts: 14
Loc: San Diego, CA
I am looking for opinions on the use of Ambien or other sleep aids prior to hiking Whitney. I realize this is not a substitute for the advice of my own physician, but I assume there is experience out there regarding this topic. I am a 45 year old female in good health and reasonably fit. I have successfully day-hiked Whitney three times and have one unsuccessful summit attempt, which I attribute to lack of sleep and possible AMS. I do not experience any symptoms of AMS when I hike Baldy or San Jacinto. I use Diamox only on Whitney, just in case. I take a low dose of Diamox the night before our hike and another dose 12 hours later. I do not use any other medications except for the occasional ibuprofen.

The inability to get good sleep prior to our hike is one of the most difficult parts of hiking Whitney for me. One year I tried Benadryl but it did not improve my sleep and if anything made me more groggy. Has anyone tried Ambien prior to hiking? Would I be able to wake up at 2:00 a.m.? Are there bad side effects that with the addition of altitude and Diamox would compromise my health or my hike? Are there other more natural sleep aids that are recommended? I appreciate any advice and opinions on the subject. Thanks very much.

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#38404 - 07/08/14 08:16 AM Re: Ambien or other sleep aids [Re: JoB]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
I suffer from the same malady. Melatonin plus a sleep app on my iphone help (there are sleep apps for progressive relaxation and sleep). I also use Diamox in small doses above 11K sleeping altitude.

Weirdly, for me, the problem does not seem to be altitude based (I slept phenomenally in Nepal, where I slept in tea houses). I just cannot sleep easily in a tent.

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#38418 - 07/08/14 11:58 AM Re: Ambien or other sleep aids [Re: Akichow]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1015
Loc: Richmond, Virginia
Short-acting Ambien-type drugs are supposed to have less respiratory-depression (not a good thing at high altitude) than Valium-class benzodiazopines.

The highly respected Institute for Altitude Medicine of Peter Hackett at Telluride specifically says:

For other sleep disturbances at altitude:

Ambien (zolpidem) 5-10 mg by mouth before bedtime as needed for sleep

Ambien CR (controlled release) 12.5 mg by mouth before bedtime as needed for sleep

Lunesta (eszopiclone) 1-3 mg by mouth before bedtime as needed for sleep


Inst Alt Med

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#38431 - 07/08/14 04:57 PM Re: Ambien or other sleep aids [Re: Harvey Lankford]
saltydog Offline


Registered: 02/03/11
Posts: 1559
Loc: Valley Ford CA!!!!
I would take Harvey's advice to the bank, if I believed in banks. Tylenol PM is my go-to, but its the same sleep aid as Benadryl. I used to do melatonin when traveling long distances (it is a long clearing time for me) but did not think to try it on the trail last year. Aki's comment is interesting. I have not been diagnosed, but I have exerienced the same tent phenomenon and wonder if it could be a CO2 sensitivity or sleep apnia thing. Harvey?

From my experience, I am wondering if you are starting your Diamox too late. At the usual acclimation dose of 125 mg x 2/d, I think it takes longer to kick in and is usually more effective is started 2 days in advance of you arrival at altitude. Also, if you are not acclimating other than with the diamox, I would not be surprised to learn that nothing you do has helped that first couple of nights over 5000 ft.
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#38432 - 07/08/14 05:06 PM Re: Ambien or other sleep aids [Re: saltydog]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
Actually I have high altitude apnea (periodic breathing, Cheyne Stokes), which is why I take a small dose of diamox when I sleep above 11k. The diamox solved that problem beautifully. After a few days, I acclimatize and the apnea goes away. No more diamox needed.

My difficulty sleeping in a tent (at ANY altitude) is not oxygen related (I usually have massive venting --entire walls open). For me, it's probably a combo of just being in different surroundings (different stimuli) and the adrenaline kick of exertion in the mountains. The mind is active, and so sleep elusive.... Relaxation tapes do help me.


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#38434 - 07/08/14 05:26 PM Re: Ambien or other sleep aids [Re: Akichow]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1015
Loc: Richmond, Virginia

What she said.

AFAIK, tent CO2 or CO problems are mainly associated with being buried under snow, or using a stove or lantern. From a personal experience, I know that the seven of us in the dining tent in Nepal enjoyed the light and heat of the kerosene lamp, but I was 'paranoid' and kept my foot so that the tent door flap stayed cracked open. Trouble is, with CO poisoning, you just go to sleep and any safety-attempt like that can fail.

I searched a bit for a study on CO2 levels in sleeping campers. You would think somewhere there might be a comparison of CO2 levels with 1,2,3,4 people in 3 vs 4 season tents, and comparison of tent materials, historic and current. Would make interesting reading even if there was no problem. Surely there must be, to use a chemistry term, a 'closest packing ratio' that makes a difference.

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#38440 - 07/08/14 08:48 PM Re: Ambien or other sleep aids [Re: Akichow]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
By the way, I don't start diamox until the night that I reach altitude. For me, it is fast acting (in about an hour). Based on my sex and weight, a high altitude specialist/wilderness medicine doctor at Stanford whom I consulted a few ago recommended 62.5 mg twice a day for me. In the Sierra, I only need 62.5 mg once a day (right before sleeping); at higher altitudes, I need more. That's me. Your experience may differ. I've also discussed these issues with Harvey and appreciate his knowledge re high altitude medicine and willingness to share his thoughts.

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#38441 - 07/08/14 09:50 PM Re: Ambien or other sleep aids [Re: JoB]
JoB Offline


Registered: 07/08/14
Posts: 14
Loc: San Diego, CA
Thanks to each of you for your responses and advice. I appreciate the link to the Institute for Altitude Medicine which I will share with my doctor. For the record I don't sleep at altitude, we stay at a motel in Lone Pine. Our acclimatization habit is to spend our first afternoon at the portal, the next day at Horseshoe Meadows and the third day is our day hike. I just can't sleep period, whether from nervous excitement or trying to go to bed early to wake up at 2:00 a.m. The one year we decided we would just go at midnight since we weren't going to sleep anyway was the one time I didn't make it to the summit, so I'm wary of going sleepless again. Regardless that I'm not sleeping at altitude I will be hiking into altitude soon thereafter and want to make sure the meds, the environment and me are all getting along. I really like the idea about the iPhone app too and will be sure to try that before we go up in a few weeks. Thanks again all.

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#38447 - 07/08/14 10:41 PM Re: Ambien or other sleep aids [Re: JoB]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
I would definitely use the lowest dose available, and you have a problem: most prescription sleepers work for 6-8 hours (definitely 8 for me, but I rarely use them)----so if you are going to use them, you want to be sure you take it about 8 hours before you are going to arise, or you may be very groggy.

There is quite a bit of variation in how people respond to these things. I'd definitely try it before your trip.

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#38495 - 07/09/14 11:15 PM Re: Ambien or other sleep aids [Re: Ken]
lynn-a-roo Offline


Registered: 08/14/10
Posts: 627
Loc: OrangeCounty
Sleep is important to our lives every day. We all need to slow down and take more time for our mountain journeys. I know I and my firends always take one or two days of paid vacation for our Mt. Whitney hike. We have to cram in the drive to Lone Pine, the drive home and the hike to the summit and back to the portal in the short time span of two to three days. It's ridiculous to cram so much into a short time frame. At this pace why sleep at all. No wonder hikers walk off cliffs. Hikers should allow more time for their jouney to the summit of Mt. Whitney. The hike is not entirely about summiting, there is much more to enjoy on the Mt. Whitney trail than just the summit. Stop, take a nap under the trees, lie by Lone Pine Lake, recline at trail camp and enjoy the sight of hikers on the switchbacks and take another nap. After all your naps then go summit Mt. Whitney but before returning to Trail Camp take another nap on the summit.

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#38498 - 07/10/14 05:41 AM Re: Ambien or other sleep aids [Re: JoB]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1015
Loc: Richmond, Virginia
Originally Posted By: JoB
T I just can't sleep period, whether from nervous excitement or trying to go to bed early to wake up at 2:00 a.m. The one year we decided we would just go at midnight since we weren't going to sleep anyway was the one time I didn't make it to the summit, so I'm wary of going sleepless again.


This is from the master of empathetic mountain literature:

The waiting aggravated our impatience and we knew we would not sleep if we were to leave at 1.00 a.m. so we prepared to leave earlier. Activity appeared more desirable than the constant checking of watches in anticipation of departure.
Joe Tasker, Savage Arena, page 195

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