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Medicines for sleep

Benzodiazepines; Sedatives; Hypnotics; Sleeping pills; Insomnia - medicines; Sleep disorder - medicines

Some people may need medicines to help with sleep for a short period of time. But in the long run, making changes in your lifestyle and sleep habits is the best treatment for problems with falling and staying asleep.

Before using medicines for sleep, talk to your health care provider about treating other issues, such as:

• Anxiety
• Sadness or depression
• Alcohol or illegal drug use

Over-the-Counter Sleep Medicines

Most over-the-counter (OTC) sleeping pills contain antihistamines. These medicines are commonly used to treat allergies.

While these sleep aids are not addictive, your body becomes used to them quickly. Therefore, they are less likely to help you fall asleep over time.

These medicines can also leave you feeling tired or groggy the next day and can cause memory problems in older adults.

Sleep Medicine From Your Provider

Sleep medicines called hypnotics can be prescribed by your provider to help reduce the time it takes you to fall asleep. The most commonly used hypnotics are:

• Zolpidem (Ambien)
• Zaleplon (Sonata)
• Eszopiclone (Lunesta)
• Ramelteon (Rozerem)

Most of these can become habit-forming. Only take these medicines while under the care of a provider. You will likely be started with the lowest dose possible.

While taking these medicines:

• Try not to take the sleeping pills more than 3 days per week.
• Do not stop these medicines suddenly. You may have symptoms of withdrawal and have more trouble falling asleep.
• Do not take other medicines that can cause you to become drowsy or sleepy.

Side effects of these medicines include:

• Feeling drowsy or dizzy during the day
• Becoming confused or having problems remembering
• Balance problems
• In rare cases, behaviors such as driving, making phone calls, or eating -- all while asleep

Before taking birth control pills, cimetidine for heartburn, or medicines used to treat fungus infections, tell your provider you are also taking sleeping pills.

Other Medicines for Sleep

Some depression medicines can also be used at lower doses at bedtime because they make you drowsy. The most commonly used are trazodone and doxepin.

Your body is less likely to become dependent on these medicines. Your provider will prescribe these drugs and monitor you while you are on them.

When to Contact a Medical Professional

Side effects to watch out for include:

• Confusion or feeling extreme joy (euphoria)
• Increased nervousness
• Problems focusing, performing, or driving
• Addiction/dependency on medicines for sleep
• Morning drowsiness
• Increased risk for falls in older adults
• Problems with thinking or memory in older adults

References

Avidan AY. Sleep and its disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 101.

Bertisch SM, Buysse DJ. Pharmacologic treatment I: therapeutic approaches and implementation. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 98.

Edinger JD, Morin CM, Pigeon WR. Pharmacologic treatment III: sequenced and combined psychologic and pharmacologic treatments for insomnia. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 100.

Vaughn BV, Basner RC. Sleep disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 377.

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Review Date: 5/12/2022  

Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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