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 find and remove the cause.

By Mayo Clinic Staff

If you're regularly having trouble either falling or staying asleep (insomnia), make an appointment with your doctor. Treatment 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. Sleeping on a regular schedule, exercising regularly, avoiding caffeine and daytime naps, and keeping stress in check also are likely to help.

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.

Sleeping pills that are benzodiazepines belong to a group of medicines called central nervous system depressants, which slow down the nervous system. In comparison, newer, nonbenzodiazepine sleeping pills appear to have a safer side effect profile. 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 prescription sleeping pills used today.

Types of prescription sleeping pills

Prescription sleeping pills may help you fall asleep easier or stay asleep longer — or both. The risks and benefits of various prescription sleeping pills can differ. To find the right prescription medication to help you sleep, your doctor may:

  • Ask you several questions to get a clear picture of your sleep patterns
  • Order tests to rule out any underlying conditions that may be causing difficulty sleeping
  • Discuss options for taking prescription sleeping medication, including how often and when to take it and in what form, such as pills, oral spray or dissolving tablets
  • Prescribe a sleeping pill for a limited period of time to determine the benefits and side effects for you
  • Have you try more than one prescription sleeping pill if the first medication you take doesn't work after the full prescribed course
  • Help you determine whether there is a generic version, which is typically less expensive than brand-name drugs

Insurance companies may have restrictions on which sleeping pills are covered, and they may require that you try other approaches to your insomnia first.

Sleep medication Helps you fall asleep Helps you stay asleep Can lead to dependence
Doxepin (Silenor)    
Estazolam
Eszopiclone (Lunesta)
Ramelteon (Rozerem)    
Temazepam (Restoril)
Triazolam (Halcion)  
Zaleplon (Sonata)  
Zolpidem (Ambien, Edluar, Intermezzo, Zolpimist)  
Zolpidem extended release (Ambien CR)

Side effects of prescription sleeping pills

Always ask your doctor about potential side effects before making a decision about which sleeping pills to consider taking. Depending on the type, prescription sleeping pills may include side effects such as:

  • Dizziness or lightheadedness
  • Headache
  • Gastrointestinal problems, such as diarrhea and nausea
  • Prolonged drowsiness, more so with drugs that help you stay asleep
  • Severe allergic reaction
  • Sleep behaviors, such as sleep-driving and sleep-eating
  • Daytime memory and performance problems

Antidepressants with a sedating effect

Sometimes prescription drugs used mainly to treat depression may ease insomnia when taken in lower doses. Although widely used, these are not approved by the Food and Drug Administration for insomnia only. When insomnia is secondary to depression or anxiety, antidepressants may improve both conditions at the same time. Examples include:

  • Amitriptyline
  • Mirtazapine (Remeron)
  • Trazodone (Oleptro)
Dec. 27, 2014 See more In-depth