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10 medications for sleep: Effectiveness and more


Various medications can help people fall asleep, stay asleep, or both, such as doxepin (Silenor) and Ramelteon (Rozerem). But, there may be some risks and side effects. Several are only for short-term use.

Sleep disturbances are common. An estimated 50 to 70 million people in the United States experience chronic sleep or wakefulness conditions, which are more common in females and older individuals.

A range of medications can help people fall asleep, stay asleep, or both. Prescription sleep aids can often relieve insomnia for short periods. However, many of these medications carry risks of side effects, misuse, and dependency.

Some sleep medications interact with other substances, including other medications, alcohol, and vitamin supplements. For this reason, a person should consult a doctor before starting any new sleep medication.

This article reviews 10 medications a doctor may prescribe to help a person sleep. It also explores some nonmedical solutions for sleep issues.

Doxepin is a sleep aid with the brand name Silenor. Doctors may suggest people with insomnia use Silenor for up to 3 months. It may help a person fall asleep and stay asleep.

It is available as an immediate-release tablet in 3 and 6 milligram (mg) doses. A person should talk with a doctor about the best dose for their needs.

Doctors do not recommend Silenor for those taking monoamine oxidase inhibitors, a type of antidepressant, or people with glaucoma or urinary retention.

Silenor may cause side effects in some people. These can include:

People who are pregnant or nursing should consult a doctor before using Silenor. Parents or caregivers should only give it to children or adolescents if directed by a medical professional.

People should also not take this medication within 3 hours of a meal.

If symptoms do not clear within 7 to 10 days, a person should contact a doctor. They may need to rule out other possible causes of insomnia.

Temazepam, which has the brand name Restoril, is a benzodiazepine. This kind of medication may cause dependency and addiction if a person misuses it.

Restoril is available by prescription for the short-term treatment of insomnia. The typical prescription length is 7 tot 10 days. A doctor will generally reassess the person following this period to determine if an underlying cause is responsible for their insomnia.

People who are pregnant should not take Restoril.

Restoril can cause a variety of side effects, which may include one or more of the following:

Restoril comes in a variety of dosages, ranging from 7.5 to 30 mg. A person should talk with a doctor about the right dose for them.

Doctors can prescribe triazolam (Halcion) for the short-term treatment of insomnia, typically for 7 to 10 days.

Like Temazepam, this medication is a benzodiazepine. Because the medication has the potential for dependency and misuse, doctors do not recommend it as a long-term treatment for insomnia.

Common side effects may include:

In some people, 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

It comes in two dose sizes: 0.25 mg and 0.5 mg. A person should not exceed 0.5 mg daily.

Ramelteon (Rozerem) is a melatonin antagonist and may help a person fall asleep. Melatonin is a naturally occurring substance in the body, and by affecting melatonin receptors, Ramelteon promotes sleep and positively affects circadian rhythms.

Due to this, a doctor may prescribe Rozerem for longer-term use, unlike other medications that are indicated for short-term use.

This medication comes in a one-size dose of 8 mg. A person should not exceed a single dose daily.

Unlike many other sleep aids, Rozerem is not a controlled substance. It has a low likelihood of misuse or dependency. However, it can still cause side effects such as:

  • drowsiness
  • dizziness
  • fatigue
  • worsening insomnia

It can also cause allergic reactions in some people.

Other groups that should use caution in taking this medication may include those who:

  • are pregnant
  • have severe liver impairment
  • are taking the medication fluvoxamine
  • have had an allergic reaction to the medication in the past

Suvorexant (Belsomra) may help a person fall asleep and maintain sleep. It is only available as a brand name medication.

A person taking Belsomra has a risk of misusing the medication and developing dependency. Like other controlled substances, it can cause CNS impairments that can lead to trouble with driving and other activities.

It can also cause:

  • worsening suicidal thoughts or depression
  • complex sleep behaviors
  • sleep paralysis

Other potential side effects reported in clinical trials include:

A doctor may prescribe a 5 to 20mg dose. Clinical trials showed that higher doses could lead to more adverse reactions.

Trazodone (Desyrel) is a medication that modulates the neurotransmitter serotonin. Doctors typically use it to treat major depressive disorder. However, they may prescribe it off-label to help a person fall asleep since one of its effects is drowsiness.

The typical starting dose is 150 mg daily, divided into two doses. Doctors may increase this to a maximum daily dose of 400 mg.

However, a doctor will likely prescribe a lower amount for sleep disturbances. A 25 to 100 mg dose may help a person fall and stay asleep with fewer side effects than traditional sleep aids.

Though they may be less likely at these lower doses, this medication can still cause side effects such as:

It may also increase thoughts of suicide.

People should limit their alcohol consumption when taking Desyrel, as it can increase the effects of alcohol.

Learn more about the effect of this medication on sleep.

Doctors can prescribe estazolam (Prosom) for the short-term treatment of insomnia. It may help with falling and staying asleep.

Prosom is a benzodiazepine and has a risk of misuse and dependency. Doctors typically prescribe it for short-term help with insomnia.

A doctor may prescribe 1 mg or 2 mg tablets for insomnia treatment.

Estazolam can cause reactions such as:

  • loss of coordination
  • drowsiness
  • hypokinesia, or a reduced range of movements
  • dizziness

Eszopiclone (Lunesta) may help a person fall and stay asleep.

Lunesta is part of a drug family known as Z-drugs. These are schedule IV controlled substances that carry a risk of misuse and dependency. A person may also experience diminishing effects or increased tolerance to the medication over time.

Though generally safe, reported side effects include:

In addition, Lunesta may cause a person to engage in complex sleep behaviors, such as sleepwalking or driving while asleep. A person should discontinue use and tell their doctor if they experience these behaviors.

Parents and guardians should talk with a doctor before giving this medication to children or adolescents. Pregnant people should also consult a doctor before taking it.

The recommended starting dose for Lunesta is 1 mg. A doctor can increase this to 2 or 3 mg if needed.

Other precautions a person should be aware of before taking Lunesta include the following:

  • Safety: Higher doses can impair a person’s CNS even when awake, making driving and other complex tasks more dangerous.
  • Liver function: People with reduced liver function should avoid taking Lunesta.
  • Age: Older people should avoid taking higher doses.
  • Mental health: Lunesta may worsen depression or suicidal thoughts.
  • Allergies: It can cause an allergic reaction in some people.

Zaleplon, or Sonata, may be useful for the short-term treatment of insomnia. While it may help a person fall asleep, it does not help maintain sleep. Like eszopiclone, this is a Z-drug.

A person taking Sonata has some risk of dependency. It also has a high likelihood of misuse.

A typical adult dose is 10 mg, though some may find that 5 mg is sufficient.

Sonata can cause a variety of side effects, including:

  • drowsiness
  • dizziness
  • diarrhea
  • difficulty concentrating

Less common side effects include hallucinations, mood changes, and memory loss.

Zolpidem, which has the brand names Ambien, Intermezzo, and Zolpimist, is a sleep medication that may help with falling asleep and sleep maintenance. It is another Z-drug.

Doctors may prescribe it for short-term insomnia relief. Like some other sleep medications, it may cause complex sleep behaviors.

Zolpidem is available in a once-daily 12.5 mg extended-release form. When prescribing immediate-release zolpidem medications, they will often start with the lowest possible dose and work upward to a maximum of 10 mg per day, if necessary.

Doctors do not recommend a person take this medication during pregnancy. It can also lead to anaphylactic reactions, CNS depression, worsening depression, and withdrawal effects in some people.

Common side effects may include:

  • dizziness
  • headache
  • next-day sleepiness

When taking zolpidem-containing drugs, drowsiness and lack of alertness in the morning can result from persistently high levels of the drug in the blood. As a result, activities that require focus and alertness, such as driving, may not be advisable for those taking high doses.

Like other Z-drugs, zolpidem-containing medications carries a risk of dependency.

The table below compares the benefits and risks of these sleep medications.

Medications for sleep can provide short-term relief from insomnia.

However, many of these medications have potentially serious side effects, including complex sleep behaviors. Some sleep medications also pose a risk of dependency and misuse.

A person should talk with a doctor before and while using any sleep aid, making them aware of other substances they use and any side effects they experience.



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