
Sleeping pills can be an effective short-term solution for insomnia and other sleep disorders. However, they carry significant risks, including memory problems, falls, and even potential misuse and dependency. As such, it is important to consult a doctor before taking any sleep medication, as they can advise on the most suitable treatment for your specific needs. Prescription sleeping pills are generally stronger than over-the-counter options, and doctors will often prescribe the lowest possible dose to mitigate potential side effects. While sleeping pills can help people fall and stay asleep, they are not a cure for insomnia and should be used with caution, especially when taken over extended periods.
| Characteristics | Values |
|---|---|
| Prescription sleeping pills | Estazolam (Prosom), Zolpidem, Eszopiclone (Lunesta), Triazolam (Halcion), Ramelteon (Rozerem), Doxepin (Silenor), Trazodone, Mirtazapine (Remeron), Zolpidem tartrate, Diphenhydramine, Doxylamine succinate |
| Over-the-counter sleeping pills | Melatonin, Valerian, Antihistamines |
| Side effects | Memory problems, falls, nausea, headaches, dizziness, lightheadedness, next-day impairment, complex sleep behaviours, dependency, addiction, withdrawal symptoms, overdose, death |
| Precautions | Not recommended for long-term use, may interfere with other medications, not suitable for pregnant or breastfeeding people, may cause rebound insomnia |
| Alternatives | Cognitive-behavioral therapy, good sleep habits, natural remedies |
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What You'll Learn
- Zolpidem: A short-term insomnia treatment with a risk of dependency
- Eszopiclone: Can help fall and stay asleep but has a risk of misuse
- Doxepin: An antidepressant that is FDA-approved for treating insomnia
- Melatonin: A natural hormone that helps promote sleep
- Trazodone: Not FDA-approved for insomnia but prescribed off-label

Zolpidem: A short-term insomnia treatment with a risk of dependency
Zolpidem, also known by its brand name Ambien, is a medication used to treat insomnia. It is a central nervous system (CNS) depressant, which slows down the nervous system, helping users fall asleep faster and stay asleep throughout the night.
Zolpidem is typically prescribed for short-term use, as the body can build a tolerance to the drug, rendering it less effective over time. The usual dose is one 10mg tablet, taken just before bed, with a recommended maximum dose of 12.5mg per day. It is important to follow the instructions of a medical professional when taking this medication, as with all medications. Zolpidem is only available via prescription.
While Zolpidem can be an effective short-term solution for insomnia, it does carry a risk of dependency. It is important that users do not exceed the prescribed dose, as taking more than the recommended amount can be dangerous. Side effects of Zolpidem include a bitter or metallic taste in the mouth, dry mouth, headaches, and drowsiness. More serious side effects include allergic reactions, changes in vision, CNS depression, and mood and behavioural changes. Elderly patients are more sensitive to the effects of the drug, including confusion, dizziness, and falling.
If you are experiencing insomnia, it is important to consult a medical professional, who can advise on the best course of treatment for you.
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Eszopiclone: Can help fall and stay asleep but has a risk of misuse
Eszopiclone, also known by its brand name Lunesta, is a prescription sleep medication that can help people fall asleep and stay asleep. It is a non-benzodiazepine hypnotic drug that slows down activity in the brain to induce sleep.
Eszopiclone is generally safe and effective, with clinical studies showing that people taking the drug fell asleep 12 minutes faster than those on a placebo. It also reduced the time they were awake during the night by 17 minutes, resulting in about half an hour of extra sleep.
However, eszopiclone carries a risk of misuse and dependency, and it is classified as a Schedule IV controlled substance. It can cause complex sleep behaviours, such as sleepwalking, driving, eating, or other activities while not fully awake. These behaviours can be dangerous, and individuals may not remember them after waking up. Therefore, it is important to be aware of these risks and consult a doctor if any unusual sleep behaviours occur.
Additionally, eszopiclone may cause side effects such as an unpleasant taste, dry mouth, dizziness, and daytime drowsiness. The recommended starting dose has been lowered to 1 mg due to the risk of next-day impairment, and it should not be taken with heavy or high-fat meals. It is important to follow the directions on the prescription label and consult a doctor if sleep problems persist or worsen.
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Doxepin: An antidepressant that is FDA-approved for treating insomnia
Doctors can prescribe a number of medications to help a person fall asleep, stay asleep, or both. It's important to note that most over-the-counter sleep aids should not be taken for more than two weeks without consulting a healthcare provider, as insomnia can be a sign of an underlying medical condition. Before taking any medication to help you sleep, it is important to consider potential side effects, medical conditions, other medications you are taking, the risk of addiction, tolerance, and rebound insomnia.
Doxepin (Silenor) is a tricyclic antidepressant that has been approved by the FDA to treat insomnia. It is available only via prescription and is not a controlled substance. Doxepin is characterised by its ability to inhibit the reuptake of serotonin and norepinephrine and possesses cholinergic, histaminergic, and alpha1-adrenergic receptor blockade activities. When used at low doses of less than 10 mg, doxepin has a high affinity for the histamine H1 receptor, promoting sleep and maintaining it.
In a systematic review of randomised placebo-controlled trials, low doses of doxepin (1-6 mg/day) were found to be safe and effective in improving sleep maintenance and duration. Headaches and somnolence were the most common side effects. However, it is important to note that the review could not conclude on its short-term benefits and risks, as well as withdrawal effects, due to the small number of studies.
Doxepin has received mixed reviews, with an average rating of 5.8 out of 10 from 310 reviews for treating insomnia. While some users have reported positive experiences, with one user stating that they "slept like a baby", others have reported negative experiences, with one user sharing that they "couldn't stay asleep". It is important to consult with a healthcare professional to determine if doxepin is an appropriate treatment for insomnia and to understand the potential benefits and risks for your specific circumstances.
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Melatonin: A natural hormone that helps promote sleep
There are many different types of sleeping pills available, both over the counter and prescription-based. While prescription sleeping pills are generally stronger, they also carry a higher risk of misuse, addiction, and dependence. Tolerance can also develop over time, requiring higher doses to achieve the same effects. As such, it is always recommended to consult a healthcare professional before taking any sleep medication.
Melatonin is a hormone produced naturally by a gland in the brain. It helps regulate the body's circadian rhythm or sleep-wake cycle. Melatonin levels typically rise about two hours before bedtime, promoting a state of quiet wakefulness that helps prepare the body for sleep. While most people produce enough melatonin for sleep, some may opt for short-term melatonin supplements to help with insomnia, jet lag, or adjusting their sleep schedule.
Supplemental melatonin can be purchased over the counter and is generally safe for adults and children experiencing sleep issues. It is recommended to take 1 to 3 milligrams of melatonin two to four hours before bedtime. Creating optimal conditions for sleep, such as reducing exposure to blue and green light from electronic devices, can enhance melatonin's effects. Maintaining a consistent sleep schedule, limiting screen time, avoiding caffeine and alcohol, and sleeping in a cool, dark room are also recommended.
While melatonin is generally well-tolerated, potential side effects include drowsiness, headaches, and vivid dreams or nightmares. It is advised to use melatonin supplements for only one to two months before reassessing sleep quality. Overall, melatonin is a natural and effective option for those seeking short-term support in regulating their sleep cycles.
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Trazodone: Not FDA-approved for insomnia but prescribed off-label
Trazodone is one of the most commonly prescribed medications for insomnia. However, it is not FDA-approved for this use, and is instead prescribed off-label. Trazodone is approved by the FDA to treat depression and anxiety, but due to its sedative effect, it is often used to treat sleep disorders.
While trazodone is a popular treatment for insomnia, there is limited clinical evidence supporting its efficacy. Some studies have shown that trazodone can help people fall asleep faster and decrease nightly awakenings, but it does not significantly improve total sleep time or sleep efficiency. A 2018 Cochrane review found no significant difference in sleep efficiency or sleep quality between trazodone and a placebo. Another 2018 review found that trazodone caused more adverse effects than a placebo, including morning grogginess, dry mouth, and thirst.
Due to the limited evidence and potential side effects, organisations like the American Academy of Sleep Medicine do not recommend trazodone as a first-line treatment for insomnia. Instead, they suggest cognitive behavioural therapy for insomnia (CBT-I), which is more effective and does not carry the same risks as sleep medications.
Despite this, many healthcare providers continue to prescribe trazodone for insomnia. This may be due to a lack of awareness of the weak clinical evidence or the belief that the benefits of trazodone outweigh the risks for certain patients. It is important for patients to discuss the risks and benefits of trazodone with their healthcare provider before starting this medication.
In summary, while trazodone may be prescribed off-label for insomnia, it is not FDA-approved for this use and there are alternative treatments that may be more effective and better tolerated. Patients should always consult their healthcare provider to determine the most appropriate treatment for their individual needs.
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Frequently asked questions
Sleeping pills can have side effects and risks, so it is important to consult a doctor before taking any medication. Some common sleeping tablets include eszopiclone (Lunesta), estazolam (Prosom), triazolam (Halcion), and zolpidem.
Side effects of sleeping tablets can include memory problems, falls, and even death. Other side effects may include dizziness, lightheadedness, nausea, headaches, daytime sleepiness, and withdrawal symptoms. Additionally, there is a risk of dependence and addiction with certain sleeping pills.
Yes, some natural alternatives to sleeping tablets include melatonin, valerian, and cognitive behavioral therapy. Melatonin is a hormone naturally produced by the body that promotes sleep, while valerian is an herb that has been used as a sleep aid for hundreds of years. Cognitive behavioral therapy can help address the stressors that interfere with sleep.
Yes, it is important to consult a healthcare professional before taking any sleeping medication to ensure it is safe and appropriate for your individual needs. Sleeping tablets are generally recommended for short-term use and may not be suitable for those with a history of substance abuse, depression, or other mood problems. They should also be used with caution in pregnant or breastfeeding individuals, as the medication can pass to the fetus or baby.










































