What to know about sleep anxiety medication

If you have anxiety, it can lead to sleeping difficulties and insomnia. Similarly, if you have insomnia, it can worsen the symptoms of anxiety. Doctors can suggest lifestyle strategies, or prescribe specific drugs to help you manage anxiety and insomnia.

Medications for calming sleep anxiety

When you’re living with anxiety, you may experience heightened symptoms when going to bed and trying to sleep. This can lead to sleep disturbances and insomnia.

If you discuss your symptoms with a doctor, they may create a treatment plan that involves:

• antidepressants
• central nervous system (CNS) depressants
• benzodiazepines

These medications work by affecting chemicals in the brain known as neurotransmitters. They relax muscles, lower anxiety levels, and help you feel more relaxed and able to sleep.

Some specific medications that doctors may prescribe include:

• Doxepin (Silenor): This primarily treats insomnia, major depressive disorder (MDD), and anxiety disorders. Doxepin is a tricyclic antidepressant (TCAs) that works by affecting five different brain chemicals.
• Eszopiclone (Lunesta): This typically treats insomnia and is a central nervous system depressant medication.
• Ramelteon (Rozerem): Doctors usually prescribe this drug if you have difficulty falling asleep, a condition known as sleep-onset insomnia.
• Zolpidem (Ambien): Doctors use this short-term medication to help you fall asleep faster.
• Estazolam (ProSom): Doctors typically prescribe this in the short term to treat insomnia.
• Zaleplon (Sonata): Doctors use this to treat and manage insomnia in the short term.
• Suvorexant (Belsomra): This treats sleep-onset insomnia and helps you stay asleep if you experience repeated waking throughout the night, known as maintenance insomnia.
• Trazodone (Desyrel): This treats MDD, anxiety disorders, and insomnia.

Other benzodiazepines

More examples of benzodiazepines include:

• Alprazolam (Xanax): This treats anxiety and panic disorders.
• Clonazepam (Klonopin): This drug treats panic disorders and agoraphobia. Doctors may also prescribe this medication for some types of seizures.
• Tranxene T (Clorazepate): This typically short-term drug treats anxiety disorders and some types of seizures.
• Diazepam (Valium): This treats anxiety, muscle spasms, and alcohol withdrawal.
• Flurazepam: This primarily treats insomnia. The brand-name version, Dulmane, is no longer available.
• Lorazepam (Ativan): Lorazepam treats anxiety and is often the first medication doctors prescribe for epilepsy.
• Oxazepam: This treats anxiety disorders and alcohol withdrawal syndrome. The brand-name version, Serax, is no longer available.
• Quviviq: This mainly treats adult insomnia. A generic version of this drug is not yet available, but the active ingredient is daridorexant.
• Doral (Quazepam): This primarily treats adult insomnia.
• Restoril (Temazepam): This treats insomnia by helping people to fall and stay asleep.

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Side effects

Although the medications for insomnia and anxiety are similar, they have very different side effects.

Benzodiazepines

Benzodiazepines have varying side effects, including:

• slower breathing or taking breaths that are more shallow (respiratory depression)
• feeling drowsy and confused
• low blood pressure or fainting
• feeling shaky
• headaches
• nausea or vomiting
• diarrhea

Benzodiazepines are controlled substances with Food and Drug Administration (FDA) warnings. This is because this drug type is highly habit-forming and prone to misuse.

CNS depressants

CNS depressants can cause side effects, including:

• confusion
• headaches
• dry mouth
• dizziness

Antidepressants

Common side effects of TCAs include:

• dry mouth
• constipation
• feeling dizzy

Other types of antidepressants, like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can have side effects including:

• nausea and vomiting
• feeling shaky
• stomach pain
• dizziness
• changes to appetite

Can anxiety medications worsen insomnia or anxiety?

Anxiety medications are typically calming and should not make it difficult for you to sleep. Similarly, taking medications for insomnia should not make you feel anxious, as they aim to relax you.

Some drugs, like those prescribed for attention deficit hyperactivity disorder (ADHD), may cause sleep disturbances as they contain stimulants.

Other options for anxiety and insomnia

Before suggesting medication for insomnia, a doctor or healthcare professional may suggest some lifestyle adjustments. These can include:

• cognitive behavioral therapy for insomnia
• light therapy
• exercise
• complementary therapies like:
  • acupuncture
  • acupressure
  • homeopathy
  • reflexology

Summary

There is a close connection between insomnia and anxiety. Insomnia may make you more anxious, and anxiety may make sleeping challenging.

If nonmedical options do not help ease your symptoms, doctors may prescribe drugs for sleep anxiety. These can include antidepressants or benzodiazepines. These work by making you feel less anxious or by relaxing muscles to help you feel calm and more able to sleep.

However, the FDA warns about benzodiazepines in particular. This is because they are highly habit-forming and prone to misuse. Discussing all options with your doctor and creating an appropriate treatment plan will help ensure the best results.

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