Does Ambien cause nightmares? (+3 factors)

In this article, we will discuss whether Ambien causes nightmares or not, how Ambien causes nightmares, and what factors influence Ambien-induced nightmares. In addition to this, we will also discuss the treatment and what to do if Ambien causes nightmares.

Does Ambien cause nightmares?

Yes, Ambien (zolpidem) can cause nightmares. It is one of the most commonly reported side effects of Ambien. Ambien may lead to a rebound of REM (rapid eye movement) sleep that may cause nightmares. It does not directly cause these side effects but its impact on the REM cycle causes nightmares to occur. 

Ambien is the brand name of zolpidem which is typically used to treat insomnia, inducing sleep in the patient (1). It may cause some side effects but the intensity and frequency of these side effects may vary among different individuals. Not every person taking Ambien will experience the same side effect. 

If you are taking Ambien for insomnia and experience nightmares ten you need to consult your healthcare provider to determine the cause and modify the treatment plan according to the body’s requirements.

How does Ambien cause nightmares?

Ambien affects the brain circuits responsible for the non-REM sleep. It also slightly suppresses the REM (Rapid eye movement) sleep cycle which is associated with the dreams and nightmares (2) (3). The suppression of the REM sleep cycle causes a rebound effect which is responsible for the nightmares.

In addition, when the effects of Ambien wear off, a more concentrated REM sleep occurs which is the rebound effect of Ambien experienced by the brain (4). In this phase, more vivid and emotionally charged dreams are experienced which, for some, can be nightmares (5). 

Some studies show that Ambien enhances the emotional processing of dreams by affecting brain chemicals called GABA. Patients taking Ambien might experience nightmares because of the enhanced emotional processing of the dreams.

What factors influence Ambien-induced nightmares?

Here are some factors that may influence Ambien-induced nightmares.


Higher doses are often linked to a higher incidence of side effects. If you are taking a high dose of Ambien you are more likely to experience adverse effects which may include nightmares as well (6). 

Individual sensitivity

Not every patient taking Ambien will experience nightmares. The incidence of these effects varies from patient to patient. The variations may be due to physiological factors, genetic predisposition, age, gender and metabolic rate.

Underlying health condition

You might experience nightmares if you are suffering from some underlying health condition which may include anxiety, depression, fatigue or stress (7). Such conditions can elevate your risk of experiencing nightmares.

Concurrent medications

If you are taking concurrent medications along with Ambien then you may experience nightmares as a result of interaction between the medications. Such medications may include:

  • Sedatives
  • Antidepressants such as Lexapro, Citalopram, Zoloft
  • Antipsychotics
  • Antihistamines
  • Antibiotics
  • Antifungals
  • Anti-seizures


Sudden withdrawal of Ambien after prolonged use may also lead to a rebound effect that can cause nightmares. If you are taking Ambien do not discontinue the medication without proper consultation. 

Sleep Quality

Disrupted sleep or changes in the pattern of sleep can create an imbalance between REM sleep and non-REM sleep which can lead to nightmares as well. 

What to do if Ambien causes nightmares?

If you are taking Ambien and experience nightmares then you need to consult your healthcare provider. 

Consulting healthcare provider

Your healthcare provider will take your past medical history to check for any possible interactions between Ambien or any of the medications you are taking already or any other condition that may be present in the body. Your doctor will help you determine the cause and modify your treatment plan according to your requirements.   

Your doctor might lower your dose as lowering the dose may potentially decrease the intensity of the REM sleep you the incidence of nightmares may also reduce. 

If nightmares do not stop even after the modifications in the treatment plan then your doctor will suggest you to switch the medication to the one that has a lower risk of nightmares. However, if your nightmares are intense or repetitive then consulting a therapist can be the best option. 

Alternatives to Ambien

Alternatives to Ambien may include the following:

  • Eszopiclone
  • Zaleplon
  • Ramelteon

Antidepressants such as trazodone, amitriptyline or doxepin can be helpful as off-label treatment strategies. In addition to this, congnitive behavioural therapies (CBT-I) are also available and can be helpful for the treatemnt of insomnia. 

In my opinion, Ambien can cause nightmares as a commonly reported side effect of the medication. However, the incidence, severity or intensity may vary among individuals taking Ambien for insomnia. Nightmares in oatient taking Ambien is not a direct side effect of Ambien. It occurs due to the modulation of REM sleep cycle. 

If you are experiencing consistent nightmares after taking Ambien then you need to consult your healthcare provider and communicate openly with them to discuss your consition and look for a suitable treatment option. 




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Bouchette, D. (2022, October 1). Zolpidem. StatPearls – NCBI Bookshelf.


Priest, R. G., Terzano, M. G., Parrino, L., & Boyer, P. (1997, January 1). Efficacy of zolpidem in insomnia. European Psychiatry.


Besset A, Tafti M, Villemin E, Borderies P, Billiard M. Effects of zolpidem on the architecture and cyclical structure of sleep in poor sleepers. Drugs Exp Clin Res. 1995;21(4):161-9. PMID: 8529530.


Pagel, J. F., & Parnes, B. L. (2001). Medications for the Treatment of Sleep Disorders: An Overview. Primary care companion to the Journal of clinical psychiatry, 3(3), 118–125.


Feriante, J. (2023, October 29). REM Rebound Effect. StatPearls – NCBI Bookshelf.


Salvà P, Costa J. Clinical pharmacokinetics and pharmacodynamics of zolpidem: therapeutic implications. Clin Pharmacokinet. 1995;29(3):142–153. [PubMed] [Google Scholar]


Akkaoui, M. A., Lejoyeux, M., d’Ortho, M. P., & Geoffroy, P. A. (2020). Nightmares in Patients with Major Depressive Disorder, Bipolar Disorder, and Psychotic Disorders: A Systematic Review. Journal of clinical medicine, 9(12), 3990.