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Effective sleep medications: The list

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Prescription medsOver-the-counter aidsMeds for anxiety-induced insomniaCautionTaperingSummary
Sleep medications such as Ambien, Lunesta, and Restoril help treat insomnia. They may also lead to side effects in some people, such as drowsiness, dizziness, and dependence, if not used as directed.
Medically reviewed by Jennie Olopaade, PharmD, RPH
Written by Rashida Ruwa, RN
Updated on November 10, 2023

Healthcare professionals often prescribe sleep medications short term to help regulate sleep patterns and provide temporary relief from insomnia and other sleep disturbances. 

Insomnia is a sleep disorder marked by difficulty staying asleep or falling asleep. It may manifest as delayed sleep onset, waking up often during the night, or waking up too early in the morning and having trouble falling back asleep. 

Insomnia may be acute and temporary (a few nights) or chronic and persistent (at least 3 nights a week for 3 months or longer).

Common triggers for insomnia may include anxiety, stress, chronic pain, and other underlying factors.

Prescription sleep medications

Woman in bed taking the most effective sleeping medication
rbkomar/Getty Images

Prescription sleep medications are classified as sedative hypnotics. They help induce relaxation and sleep. Common examples include:

  • zolpidem
    • Brand name: Ambien
    • Dosage: Doctors typically prescribe 5–10 milligrams (mg) once daily, taken before bedtime.
    • Frequency: People usually take it as needed when experiencing sleep difficulties; it is not recommended for daily use.
    • Side effects: Dizziness, nausea, drowsiness, and changes in taste perception are common side effects. Rarely, it may cause sleep driving or sleepwalking, and behavioral changes.
  • eszopiclone
    • Brand name: Lunesta
    • Dosage: The usual dosage ranges from 1–3 mg once daily, taken at bedtime. 
    • Frequency: Experts recommend taking it nightly until sleep patterns improve, but people should use it short term (2–3 weeks) to avoid dependence.
    • Side effects: Drowsiness, headache, and unpleasant taste are commonly reported side effects.  
  • temazepam
    • Brand name: Restoril
    • Dosage: The usual dosage is 15–30 mg once daily, taken shortly before bedtime.
    • Frequency: Doctors often prescribe it for short-term use, usually 7–10 days.
    • Side effects: These may include drowsiness, dizziness, and blurred vision.
  • zaleplon
    • Brand name: Sonata
    • Dosage: The usual dosage is 5–20 mg once daily, taken at bedtime.
    • Frequency: Doctors prescribe it for short-term relief of insomnia, and people often take it as needed for up to 2 weeks.
    • Side effects: Common side effects include dizziness, drowsiness, and changes in taste perception.

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OTC sleeping aids

Common over-the-counter (OTC) sleeping aids may include:

Diphenhydramine (Benadryl)

Diphenhydramine (Benadryl) is a sedative antihistamine sometimes used for temporary insomnia. It is not a first-line treatment for sleep disturbances, and discussing its use for this purpose with a healthcare professional is highly encouraged.

  • Dosage: The typical dosage is 25 mg before bed; adhere to package instructions.
  • Frequency: It is intended for occasional use; avoid prolonged or daily intake.
  • Side effects: Drowsiness, dry mouth, and dizziness are common side effects.
  • Warnings: OTC doesn’t mean risk-free. Do not drink alcohol or engage in activities requiring alertness when using diphenhydramine (Benadryl).

Doxylamine (Unisom)

Doxylamine is another antihistamine that may be used for sleep challenges under a doctor’s supervision.

  • Dosage: The typical dosage is 25–50 mg before sleep, as needed.
  • Frequency: It is intended for short-term use — usually no more than 2 nights in a row.
  • Side effects: Similar to diphenhydramine, it may cause dizziness, drowsiness, and dry mouth.
  • Warnings: It is best to exercise caution and avoid alcohol and activities that require full alertness during use.

Precautions when using OTC sleeping aids:

  • Consider talking with a doctor before using any product marketed as an OTC sleep aid, especially if you have underlying medical conditions or are taking other medications.
  • Do not exceed the recommended dosage, and always follow the instructions on the packaging.
  • OTC sleep aids are meant for short-term use. Prolonged or daily use can lead to tolerance and dependence.

Medications for anxiety-induced insomnia

Insomnia is common among people with anxiety disorders, and there are several medications available to help manage both anxiety and the associated sleep disturbances, including:

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Tricyclic antidepressants (TCAs)

TCAs may be effective for managing anxiety-induced insomnia.

Examples may include:

Commonly reported side effects include:

  • dry mouth
  • dizziness
  • constipation

Serotonin antagonist reuptake inhibitors (SARIs)

Healthcare professionals may occasionally recommend SARIs in a low dose of 25 mg to manage anxiety-induced insomnia.

A common example is trazodone (Desyrel), which people often use off-label to manage insomnia because of its sedative properties, especially with lower doses.

Typical side effects include:

  • dry mouth
  • drowsiness
  • blurred vision

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are medications used to manage depression and anxiety. They may help you sleep better, as they relieve anxiety symptoms, but doctors may not recommend them for treating other causes of insomnia.

Examples may include:

SSRIs may worsen insomnia symptoms in some people. Only a healthcare professional may identify which medication works better for your overall needs.

Other side effects may include:

  • diarrhea
  • dry mouth
  • sweating
  • headaches

Benzodiazepines 

Usually used as a last resource and for short periods of time, benzodiazepines may provide relief from severe anxiety and insomnia. People typically take them on an “as-needed” basis due to the potential for dependence and tolerance with prolonged use.

Potential side effects include:

  • drowsiness
  • dizziness
  • risk of dependence

Common examples include:

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A word of caution

Sleep medications may not be appropriate for everyone, and healthcare professionals recommend avoiding them if you:

  • are pregnant or nursing
  • have a history of substance use
  • live with certain medical conditions or allergies

When using sleep medications, consider avoiding the following:

  • Alcohol: It can intensify the sedative effects of these medications and increase the risk of adverse reactions.
  • Other medications: Sleep medications may interact with other medications. Therefore, consider speaking with a healthcare professional about all your medications to avoid drug interactions.
  • Operating machinery: Refrain from activities requiring alertness, like driving.

Should you taper off sleeping medications?

Your healthcare professional may recommend that you taper off sleep medications, especially if you’ve been using them regularly.

Gradually reducing your dosage helps minimize the risk of withdrawal symptoms and dependence.

Summary

Prescription sleep medications offer targeted solutions, while OTC sleeping aids may relieve occasional sleep troubles. For anxiety-induced insomnia, consider talking with a healthcare professional to explore possible treatments for anxiety and related symptoms. 

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