Ten sleep-aiding medications: Their efficacy and further details
Different medications can assist individuals in falling asleep, staying asleep, or both, such as doxepin (branded as Silenor) and Ramelteon (Rozerem). However, these medications may come with certain risks and side effects. Many are only intended for short-term use.
Sleep disturbances are quite common, with an estimated number of people in the United States suffering from chronic sleep or wakefulness conditions. These conditions are more prevalent among females and older individuals.
A variety of medications can aid in falling asleep, staying asleep, or both. Prescription sleep aids can often alleviate insomnia for a short period. However, these medications may carry risks of side effects, misuse, and dependency.
Certain sleep medications interact with other substances, including other medications, alcohol, and vitamin supplements. Therefore, it's essential to consult a healthcare professional before starting any new sleep medication.
This article discusses 10 medications that doctors might prescribe to aid sleep. It also explores some nonmedical solutions for sleep issues.
1. Doxepin
Doxepin, marketed as Silenor, is a sleep aid. Medical professionals might recommend Silenor to individuals experiencing insomnia for up to 3 months. It can help a person fall asleep and stay asleep.
may help a person fall and stay asleep
It is available as an immediate-release tablet in 3 mg and 6 mg doses. The optimal dose depends on the individual's needs and should be discussed with a healthcare professional.
• may interact with other medications • may not be suitable for pregnant people
Silenor is not recommended for those taking monoamine oxidase inhibitors or individuals with glaucoma or urinary retention.
yes
Silenor may cause side effects in some people, such as:
yes
- central nervous system (CNS) depression
- worsening depression or suicidal thoughts
- unusual thinking patterns and behavior changes
unlikely
Pregnant or nursing women should consult a doctor before using Silenor. Parents or caregivers should only administer it to children or adolescents if directed by a healthcare professional.
• CNS depression• changes in mood or behavior• suicidal thoughts
Silenor should not be taken within 3 hours of a meal.
If symptoms persist beyond 7 to 10 days, a person should contact their doctor. They may need to rule out other possible causes of insomnia.
strong sedative effect may help with insomnia
2. Temazepam
risk of dependency, withdrawal, and misuse
Temazepam, marketed as Restoril, is a benzodiazepine. Misuse of this type of medication can result in dependency and addiction.
yes
Restoril is prescribed for short-term treatment of insomnia, typically for 7 to 10 days. After this period, a doctor will evaluate the individual to determine if an underlying cause is responsible for their insomnia.
yes
Individuals who are pregnant should not take Restoril.
yes
Restoril can cause a variety of side effects, such as:
• dry mouth• vertigo• headache• fatigue• nausea• anxiety• depression
- drowsiness
- fatigue
- headache
- nausea
- dizziness
- dry mouth
- vertigo
- anxiety
- depression
- diarrhea
- confusion
- nightmares
Restoril is available in various dosages, ranging from 7.5 mg to 30 mg. The optimal dose depends on the individual and should be discussed with a healthcare professional.
may help a person fall and stay asleep and is generally safe
3. Triazolam
can cause complex sleep behaviors, such as sleepwalking
Triazolam, marketed as Halcion, can be prescribed by doctors for the short-term treatment of insomnia, typically for 7 to 10 days.
yes
Like Temazepam, this medication is a benzodiazepine. Due to the potential for dependency and misuse, it is not recommended for long-term treatment of insomnia.
yes
Common side effects may include:
yes
- ataxia, or a lack of muscle coordination
- drowsiness
- dizziness
- lightheadedness
• dizziness• unpleasant taste• viral infections • headache• anxiety
Halcion can cause:
- complex sleep behaviors
- dependency
- withdrawal symptoms when a person suddenly stops taking it
- worsening insomnia
- CNS issues such as changes in behavior, unusual thinking, and anxiety
- worsening depression
- issues with performing activities such as driving
not a controlled substance and has little chance of causing dependency
It comes in two dose sizes: 0.25 mg and 0.5 mg. A person should not exceed 0.5 mg daily.
has the potential for adverse and allergic reactions in some people
4. Ramelteon
yes
Ramelteon, marketed as Rozerem, is a melatonin antagonist. By affecting melatonin receptors, it promotes sleep and positively affects circadian rhythms.
no
Due to this, a doctor may prescribe Rozerem for longer-term use, unlike other medications that are indicated for short-term use.
unlikely
Help is available if you or someone you know is in crisis and considering suicide or self-harm:
• drowsiness• dizziness• fatigue• worsening insomnia
- Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
may help a person fall and stay asleep
If you’re not in the same household, stay on the phone with them until help arrives.
risk of dependency or misuse
This medication comes in a standard dose of 8 mg. An individual should not consume more than a single dose per day.
yes
Contrary to many other sleep aids, Rozerem is not a controlled substance. Misuse or dependency is less likely due to its unique properties. However, it can still produce side effects such as:
yes
- excessive drowsiness
- feelings of dizziness
- lack of energy
- aggravation of insomnia
yes
Allergic reactions are also possible for certain individuals.
• diarrhea• dry mouth• upper respiratory tract infection • headache
Individuals who should exercise caution when using this medication might include:
- pregnant women
- individuals with severe liver impairment
- those taking the drug fluvoxamine
- individuals who have had an adverse reaction to the medication in the past
may help a person fall asleep
5. Suvorexant (Belsomra)
only for short-term use
Suvorexant might assist an individual in falling asleep and staying asleep. It is only available under the brand name.
yes
Taking Belsomra carries a risk of misuse and dependency, much like other controlled substances. It can lead to CNS impairment, making tasks like driving more challenging.
no
Belsomra can also cause:
yes
- worsening of suicidal thoughts or depression
- unusual sleep behaviors
- sleep paralysis
• lack of coordination• drowsiness• dizziness• lightheadedness
Other side effects reported in clinical trials include:
- diarrhea
- dry mouth
- respiratory tract infection
- headache
- dizziness
- bizarre dreams
- cough
low dose antidepressant that may cause fewer side effects than traditional sleep medications
A healthcare provider may prescribe a dose between 5 to 20 mg. Higher doses could lead to more adverse reactions.
can cause mental health side effects, such as suicidal ideation
6. Trazodone (Desyrel)
yes
Trazodone, which affects the neurotransmitter serotonin, is a medication typically used to treat major depressive disorder. Doctors may also prescribe it off-label to aid in falling asleep due to its sedative properties.
yes
The typical starting dose is 150 mg daily, divided into two doses. Doctors might boost this to a maximum daily dose of 400 mg.
unlikely
However, a doctor will likely prescribe a lower amount for sleep disturbances. A dose may help an individual fall and stay asleep with fewer side effects than traditional sleep aids.
• edema• drowsiness• blurred vision• weight loss• suicidal thoughts
Though less likely at lower doses, this medication can still lead to side effects such as:
- fluid retention, where the body's tissues retain too much fluid
- drowsiness
- blurred vision
- fainting
- weight loss
- fatigue
- diarrhea
- nasal congestion
may help a person fall and stay asleep
It may also increase thoughts of suicide.
risk of dependency or misuse
Individuals should limit their alcohol intake when taking Desyrel, as it can amplify the effects of alcohol.
yes
Learn more about Desyrel's impact on sleep.
yes
7. Estazolam (Prosom)
yes
Doctors may prescribe estazolam for the short-term treatment of insomnia. It may aid in falling and staying asleep.
• lack of coordination• drowsiness• reduced movements• dizziness
Prosom is a benzodiazepine, which can lead to dependency. Doctors typically prescribe it for temporary help with insomnia.
A doctor may prescribe 1 mg or 2 mg tablets for insomnia treatment.
may help a person fall asleep
Estazolam can induce reactions such as:
• risk of dependency and adverse effects• does not help maintain sleep
- loss of coordination
- drowsiness
- reduced range of movements, or hypokinesia
- dizziness
yes
8. Eszopiclone (Lunesta)
no
Eszopiclone (Lunesta) might assist an individual in falling and staying asleep.
yes
Lunesta falls under the Z-drug classification, which poses a risk of misuse and dependency. A person may experience diminished effects or increased tolerance to the medication over time.
• abdominal pain• weakness • headache
Common side effects include:
- dizziness
- an unpleasant taste in the mouth
- viral infections
- headache
- anxiety
- dry mouth
- rash
- hallucinations
may help a person fall and stay asleep
In addition, Lunesta may cause an individual to engage in complex sleep behaviors, such as sleepwalking or driving while asleep. Individuals should discontinue use and inform their doctor if they encounter these behaviors.
may cause complex sleep behaviors and other adverse reactions
Parents and guardians should speak with a doctor before administering this medication to children or adolescents. Pregnant individuals should also consult a doctor before taking it.
yes
The recommended starting dose for Lunesta is 1 mg. A doctor may increase this to 2 or 3 mg if needed.
yes
Other precautions an individual should consider before taking Lunesta include:
yes
- Safety: Higher doses can impair an individual's CNS even when awake, making driving and other complex tasks more dangerous.
- Liver function: Individuals with reduced liver function should avoid taking Lunesta.
- Age: Older people should avoid taking higher doses.
- Mental health: Lunesta may exacerbate depression or suicidal thoughts.
- Allergies: It can cause an allergic reaction in some individuals.
• dizziness• headache• next-day sleepiness
9. Zaleplon (Sonata)
Zaleplon, or Sonata, might be helpful for the short-term treatment of insomnia. While it may aid in falling asleep, it does not help maintain sleep. Like eszopiclone, this is a Z-drug.
An individual taking Sonata has a risk of dependency. It also has a high likelihood of misuse.
A typical adult dose is , though some may find that 5 mg is sufficient.
Sonata can induce a wide range of side effects, including:
- drowsiness
- dizziness
- diarrhea
- difficulty focusing
Less common side effects include hallucinations, mood changes, and memory loss.
Zolpidem, readily available under the names Ambien, Intermezzo, and Zolpimist, is a sleep medication that could aid in initiating sleep and sustaining it. It falls under the category of Z-drugs, similar to other sleep medications.
Doctors might prescribe it for temporary sleep disturbance management. Like some other sleep aids, it might induce intricate sleep activities.
Zolpidem is administered in a once-daily 12.5 mg extended-release format. When prescribing immediate-release zolpidem, healthcare providers usually initiate with the minimal dose, escalating up to a maximum of 10 mg daily, if necessary.
Medical experts discourage its usage during pregnancy. It may lead to severe allergic reactions, central nervous system depression, worsened depression, and withdrawal symptoms in certain individuals.
Common side effects include:
- lightheadedness
- headache
- post-sleep drowsiness
Persistent high levels of zolpidem in the bloodstream arising from zolpidem-containing medications might cause drowsiness and decreased alertness, especially for those taking high doses. Consequently, activities requiring focus and alertness, such as driving, can be impacted.
Zolpidem, like other Z-drugs, has a risk of dependency.
Comparison table
The table below provides insights into the advantages and disadvantages of these sleep medications.
| Medication brand name | Advantages | Disadvantages | Can it assist with sleep onset? | Can it aid in sustained sleep? | Risk of dependency and misuse? | Side effects || --- | --- | --- | --- | --- | --- | --- || Silenor | may aid sleep onset and maintenance | may interact with other medications, unsuitable for pregnant people | yes | yes | unlikely | • Central nervous system depression• mood or behavior changes• suicidal thoughts || Restoril | potent sedative effect may help insomnia | dependency, withdrawal, and misuse risk | yes | yes | yes | • Dry mouth• vertigo• headache• fatigue • nausea • anxiety • depression || Lunesta | may aid sleep onset and maintenance, generally safe | can induce complex sleep behaviors like sleepwalking | yes | yes | yes | • Dizziness• unpleasant taste• viral infections • headache• anxiety || Rozerem | not a controlled substance, minimal dependency risk | adverse reactions and allergies potential | yes | no | unlikely | • Drowsiness• dizziness• fatigue• worsened insomnia || Belsomra | may aid sleep onset and maintenance | dependency and misuse risk | yes | yes | yes | • Diarrhea• dry mouth• respiratory infection • headache || Halcion | may aid sleep onset | for temporary use only | yes | no | yes | • Lack of coordination• drowsiness• dizziness• lightheadedness || Desyrel | low dose antidepressant, fewer side effects | may cause mental health side effects, such as suicidal ideation | yes | yes | unlikely | • Swelling• drowsiness• blurred vision• weight loss• suicidal thoughts || Prosom | may aid sleep onset and maintenance | risk of dependency or misuse | yes | yes | yes | • Lack of coordination• drowsiness• reduced movements• dizziness || Sonata | may aid sleep onset | dependency and adverse effects risk, does not improve sustained sleep | yes | no | yes | • Abdominal pain• weakness • headache || Ambien, Intermezzo, Zolpimist | may aid sleep onset and maintenance | may induce complex sleep behaviors and other adverse reactions | yes | yes | yes | • Dizziness• headache• next-day drowsiness |
Other sleep disorder treatments
Although medications may help some individuals with insomnia, alternative therapies and lifestyle changes may also assist in falling asleep. Potential solutions could include:
- Herbal remedies such as supplements or teas
- Relaxation techniques
- Practicing healthy sleep habits, including sleeping in a cool, dark room and avoiding distractions and large meals before bedtime
- Exercise increase
- Cognitive behavioral therapy
For comprehensive sleep science-related resources, check out our dedicated hub.
Summary
Medications can alleviate short-term insomnia but may have serious side effects, such as complexity in sleep behaviors. Some sleep medications could also pose risks associated with dependency and misuse. Discuss any sleep aid use with a healthcare provider, providing information on other substances utilized and experienced side effects.
The use of medication to manage insomnia can provide temporary relief for some individuals, as shown in the case of Doxepin (Silenor). Although it may aid in falling and staying asleep, it's crucial to be aware of the potential side effects, such as central nervous system depression, worsening depression, and suicidal thoughts, and to follow dosage guidelines carefully. Consulting a healthcare professional before starting any new sleep medication is essential, especially considering interactions with other substances.
