Ambien vs. All-Nighter

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The Dark Knight

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For those that just stay up the entire night, any recs on energy/caffeine drinks to help you survive. i've heard good things about 5-hour energy. tia
 
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My roommate used ambien after cancelling his step 1 because he couldnt sleep the night before and was afraid to take the test. It seemed to work well for him. I've never used a sleeping aid so I can't speak directly to it.


As for caffeine, 5 hour energy has never worked for me, I like AMP energy drink because I can't stand the taste of red bull. But those larger caffeine drinks def seem to make me 'feel it' when the 5 hour energy doesn't seem to affect me at all.
 
Any of you out there have a history of not being able to fall asleep the night before the test? The anticipation of what will be asked, or dreaming of the minute you hit submit and are done, keeps you up all night?

Just wondering what works for anyone out there to get sleep? I didn't sleep before step 1 and that was no fun. Hoping not to repeat. Any of you try ambien? For those that just stay up the entire night, any recs on energy/caffeine drinks to help you survive. i've heard good things about 5-hour energy. tia

I have always had the anxiety-induced insomnia before exams, so for USMLE I just scheduled the 12pm or 1pm start times. I would still go to bed as if my test is at 8am (get into bed around 10pm)...and when I eventually fell asleep 6 hours later, I was still all good.
 
I got absolutely zero sleep before step 1, came damn close to cancelling that time. I hope to god I don't repeat again.
 
Any of you out there have a history of not being able to fall asleep the night before the test? The anticipation of what will be asked, or dreaming of the minute you hit submit and are done, keeps you up all night?

Just wondering what works for anyone out there to get sleep? I didn't sleep before step 1 and that was no fun. Hoping not to repeat. Any of you try ambien? For those that just stay up the entire night, any recs on energy/caffeine drinks to help you survive. i've heard good things about 5-hour energy. tia

Had a similar experience, and I think it hurt my step 1 score somewhat. Started Ambien shortly after that PRN (rarely) and definitely took one the night before Step 2. I'd also add that 1/2-3/4 of a tablet seems to work better for me and I feel less groggy in the morning. I also tended to take one the night before my shelf exams. Definitely helped.

i was also much less nervous about Step 2...partly because I knew what to expect, and partly because I was very confident in my abilities this time around...so less test anxiety.

Now that the steps are over, I haven't touched my bottle. Sleeping like a baby now! 😀
 
Alcohol. 2 glasses of wine at 10pm the night before worked wonders. Was sleeping by 11:30. I wish I had done this for step 1.
 
Two things:

1) If you go with Ambien, make sure you go to bed early enough to get 6-8 hours of uninterrupted sleep.

2) Whatever you do, do NOT go with an antihistamine. They will leave you groggy in the morning and some studies show significantly decreased test performance after using them.
 
Ambien or melatonin??????? Any recommendations? People have suggested melatonin to me. Thoughts?

You can try the melatonin first (I did), but the studies show a pretty low success rate (something like 10% or so, I think), so it doesn't work for everyone. But, worth trying I guess. All the sleep hygiene stuff should come first.
 
You can try the melatonin first (I did), but the studies show a pretty low success rate (something like 10% or so, I think), so it doesn't work for everyone. But, worth trying I guess. All the sleep hygiene stuff should come first.

Surely we don't need to follow the advice we give patients, right :laugh:
 
Melatonin can make you mad depressed if you take it for awhile, so I'd recommend just using for the times it's really useful (jet-lag).
 
Two things:

1) If you go with Ambien, make sure you go to bed early enough to get 6-8 hours of uninterrupted sleep.

2) Whatever you do, do NOT go with an antihistamine. They will leave you groggy in the morning and some studies show significantly decreased test performance after using them.

Antihistamines are bad to take at night? I take a daily allergy medication at night before I go to bed. Please elaborate more and/or post some links to this info. Thank you very much 🙂
 
Antihistamines are bad to take at night? I take a daily allergy medication at night before I go to bed. Please elaborate more and/or post some links to this info. Thank you very much 🙂

I remember this bit of info from 2nd year pharmacology. I just did a cursory google search; I should have specified 1st generation antihistamines like diphenhydramine should be avoided:

1) http://biopsychiatry.com/antihistamines.htm

ABSTRACT
Allergic diseases are responsible for substantially more disability than is generally realized. Allergic rhinitis alone results in 3.5 million lost workdays and 2 million missed school days in the United States each year. Comorbid conditions such as asthma and sinusitis can be disabling as well, resulting each year in more than 10 million missed school days and more than 73 million days of restricted activity, respectively. Antihistamines continue to be the mainstay of treatment for allergic disorders. In the case of the first-generation antihistamines, however, the treatment may well be worse than the disease. Although these agents are effective H(1)-receptor antagonists, they are also highly lipophilic and readily cross the blood-brain barrier, causing considerable sedation. The second-generation agents are more lipophobic and possess different ionic charges than the first-generation antihistamines. As a result, they are far less likely to cross the blood-brain barrier and, for that reason, cause little if any sedation. In a recent comparative trial, subjects who were treated with the first-generation agent diphenhydramine were found to have significant performance deficits on tests of divided attention, working memory, vigilance, and speed. By contrast, subjects who were treated with the second-generation antihistamine loratadine performed as well as subjects who were treated with placebo. The sedative effects of the first-generation agents persist well into the next day and thus can potentially interfere with daytime performance and safety even when taken the night before. It is therefore recommended that patients whose occupations require vigilance, divided attention, or concentration receive only second-generation antihistamines.

2) http://www.ncbi.nlm.nih.gov/pubmed/8170531
Diphenhydramine causes drowsiness and performance decrements in some tasks whereas terfenadine generally does not. This study examined central nervous system (CNS) differences in response to the administration of diphenhydramine (50 mg) and terfenadine (60 mg) up to 3 h after drug administration. Two evoked potential measures, the Brainstem Auditory Evoked Potential and the Pattern Reversal Evoked Potential (PREP), assessed CNS function. Other measures of CNS function, cognitive performance and subjective states administered included Critical Flicker Fusion, the Baddeley Grammatical Reasoning Test, Digit Symbol Substitution, the Profile of Mood States, and the Environmental Symptoms Questionnaire. Significant increases in PREP latencies (N75, P100 and N145) occurred after orally ingesting diphenhydramine. No other significant drug effects were observed. The significant increase in the PREP latencies indicate diphenhydramine's presence in the cerebral cortex results in a slowing of visual information processing. The lack of significant findings for terfenadine is probably a result of its difficulty in penetrating the blood-brain barrier.
 
I would go with either Ambien or a short-acting benzodiazepine. Also, I would try it the night before a simulated exam (several weeks out) to see if it affects your performance before the real one.
 
For those that just stay up the entire night, any recs on energy/caffeine drinks to help you survive. i've heard good things about 5-hour energy. tia

That is crazy man 🙂 ... dont stay up all night! even if you slept 3-4 hours that's still much better. whoever told you to stay up all night(if someone did) wants you to fail
 
I haven't been able to fall asleep until after 2 or 3am for about a year, even if I was extremely tired I would just lie in bed for hours. I would be lucky if I got 3-5 hours of sleep a night. My doctor prescribed me Ambien 2 weeks ago. I've been getting the best sleep ever. I even wake up after 6-8 hours fully refreshed and awake. I'm just happy to be getting a normal sleep. This really works. I have no stories of waking up in the middle of the night doing odd things.

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That's so awesome for you! Could you personally hook me up? I especially like your non-chalant link on the bottom of your post. It's almost like you're promoting something...
 
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