Prescription sleeping pills: What's right for you?

Sleeping pills help when stress, travel or other disruptions keep you awake. If you have chronic insomnia, a better approach may be to remove the cause by changing your lifestyle. By Mayo Clinic Staff

If you're regularly having trouble either falling or staying asleep (insomnia), make an appointment with your doctor. Treatment is available — but it depends on what's causing your insomnia. Sometimes, an underlying medical or sleep disorder can be found and treated, a much more effective approach than just treating the symptom of insomnia itself.

Behavior changes learned through cognitive behavioral therapy are generally the best treatment for persistent insomnia. However, there are times when prescription sleeping pills may be helpful. Although sleeping pills don't treat the underlying cause of your sleeping problems, they may help you get some much needed rest.

Today's prescription sleeping pills don't carry the same level of risks of dependence and overdoses as sleeping pills of the past. But risks remain — especially for people who have certain medical conditions, including liver or kidney disease. Always talk with your doctor before trying a new treatment for insomnia.

Here's information on some of the most common types of sleeping pills used today.

Types of prescription sleeping pills

Prescription sleeping pills are available to help you fall asleep easier, stay asleep longer — or both. Before prescribing a medication to help you sleep, your doctor will ask you a number of questions to get a clear picture of your sleep patterns. He or she may also order tests to rule out any underlying conditions that may be causing difficulty sleeping.

To reduce the risk of side effects and of becoming reliant on drugs to sleep, your doctor likely will prescribe medications for two to four weeks. If the first medication you take doesn't work after the full prescribed course, call your doctor. You may need to try more than one prescription sleeping pill before finding one that works for you.

Some prescription sleeping pills are available as generic drugs, which are typically less expensive than are brand-name drugs. Ask your doctor whether there is a generic version available of the medication he or she prescribes. Insurance companies may have restrictions on which sleeping pills are covered, and they may require that you try other approaches to your insomnia first.

Sleeping pills that help you fall asleep

The following prescription medications are used mainly to help you fall asleep.

Drugs that help you fall asleep
Drug May not be safe if you: Considerations
Eszopiclone (Lunesta) Have a history of drug or alcohol abuse, depression, lung disease, or a condition that affects metabolism.

May be used for a longer period of time than zolpidem or zaleplon.

High-fat meals may slow your absorption of the drug and make it less effective.

Stopping the drug suddenly may cause symptoms of withdrawal, such as anxiety, unusual dreams, nausea and vomiting.
Ramelteon (Rozerem)

Are pregnant or breast-feeding.

Have a history of kidney or respiratory problems, sleep apnea, or depression.

Have a liver disease.

May interact with alcohol.

High-fat meals may slow your absorption of the drug and make it less effective.

A manufactured drug similar to melatonin. Not likely to be habit-forming.
Triazolam (Halcion)

Are pregnant or breast-feeding.

Have a history of drug abuse, depression or respiratory conditions.

May interact with grapefruit juice, alcohol and many medications.

Can be habit-forming. Seldom prescribed by sleep specialists.

Drug must be stopped gradually.
Zaleplon (Sonata)

Have severe liver problems.

Are pregnant or breast feeding.

Have a history of depression, liver or kidney disease, or respiratory conditions.

May interact with other medications. 

Can be habit-forming.

High-fat meals may slow your absorption of the drug and make it less effective.

Very short acting, so can be taken in the middle of the night following precautions from your doctor.

Zolpidem (Ambien, Edluar) Have a history of depression, liver or kidney disease, or respiratory conditions.

May become less effective over time.

Sleep behaviors, such as sleep-driving and sleep-eating may occur.

Sleeping pills that help you stay asleep

The following prescription medications are used to help you get to sleep and stay asleep.

Drugs that help you stay asleep
Drug May not be safe if you: Considerations
Estazolam Are pregnant, breast-feeding, or are an older adult.

May interact with many other medications.

Can be habit-forming.
Eszopiclone (Lunesta) Have a history of drug or alcohol abuse, depression, lung disease, or a condition that affects metabolism.

High-fat meals may slow absorption of the drug and make it less effective.

Stopping the drug abruptly may cause symptoms of withdrawal such as anxiety, unusual dreams, nausea and vomiting.
Temazepam (Restoril)

Have a history of severe depression, substance abuse, lung disease, or kidney or liver problems.

Are pregnant or breast-feeding.

May interact with alcohol and many medications.

Can be habit-forming.
Zolpidem (Ambien CR)

Have a history of depression, liver or kidney disease, or respiratory conditions.

Are pregnant or breast-feeding.

This extended-release formula may be used for a longer period of time than regular zolpidem or zaleplon.
Doxepin (Silenor)

Have a history of glaucoma, trouble urinating (urinary retention) or heart disease.

May cause weight gain.
Dec. 02, 2011 See more In-depth