In some cases, doctors will prescribe drugs for the treatment of insomnia. All insomnia medications should be taken shortly before bed. Do not attempt to drive or perform other activities that require concentration after taking an insomnia drug because it will make you sleepy. Medications should be used in combination with good sleep practices.
Listed below are some drugs that can be used to treat insomnia.
- zolpidem ( Ambien , Edluar, Intermezzo): These medicines work well at helping you get to sleep, but some people tended to wake up in the middle of the night. Zolpidem is now available in an extended release version, Ambien CR. This may help you go to sleep and stay asleep longer. There is, however, a warning from the FDA that you should not drive or perform any activities that require you to be alert the day after taking Ambien CR because it stays in the body a long time. You should not take zolpidem unless you are able to get a full night's sleep -- at least 7 to 8 hours. The FDA has approved a prescription oral spray called Zolpimist, which contains zolpidem, for the short-term treatment of insomnia brought on by difficulty falling asleep.
- eszopiclone ( Lunesta ): Lunesta also helps you fall asleep quickly, and studies show people sleep an average of seven to eight hours. Don't take Lunesta unless you are able to get a full night's sleep as it could cause grogginess. Because of the risk of impairment the next day, the FDA recommends the starting dose of Lunesta be no more than 1 mg.
- ramelteon ( Rozerem ): This is a sleep medication that works differently than the others. It works by targeting the sleep-wake cycle, not by depressing the central nervous system. It is prescribed for people who have difficulty falling asleep. Rozerem can be prescribed for long-term use, and the drug has shown no evidence of abuse or dependence.
- zaleplon ( Sonata ): Of all the newer sleeping pills, Sonata stays active in the body for the shortest amount of time. That means you can try to fall asleep on your own. Then, if you're still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning. However, if you tend to wake during the night, this might not be the best choice for you.
- doxepine ( Silenor ): This sleep drug is approved for use in people who have trouble staying asleep. Silenor may help with sleep maintenance by blocking histamine receptors. Do not take this drug unless you are able to get a full seven or eight hours of sleep. Dosage is based on your health, age, and response to therapy.
- suvorexant (Belsomra). It’s been on the market for about a year.
- Benzodiazepines: These older sleeping pills -- triazolam (Halcion), temazepam (Restoril), and others -- may be useful when you want an insomnia medication that stays in the system longer. For instance, they have been effectively used to treat sleep problems such as sleepwalking and night terrors. However, these drugs may cause you to feel sleepy during the day and can also cause dependence, meaning you may always need to be on the drug to be able to sleep.
- Antidepressants : Some antidepressant drugs, such as trazodone (Desyrel), are particularly effective in treating sleeplessness and anxiety.
- Over-the-Counter Sleep Aids: Most of these sleeping pills are antihistamines. There is no proof that they work well for insomnia, and they can cause some drowsiness the next day. They're safe enough to be sold without a prescription. However, if you're taking other drugs that also contain antihistamines -- like cold or allergy medications -- you could inadvertently take too much.
In 2007, the FDA issued warnings for prescription sleep drugs, alerting patients that they can cause rare allergic reactions and complex sleep-related behaviors, including "sleep driving." In 2013, the FDA also warned people that taking sleeping medication at night can impair their ability to drive or be fully alert -- even the next day.