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 and can increase your risk for accidents. Medications should be used in combination with good sleep practices.
Types of Sleep Disorder Medications
Listed below are some of the types of drugs used to treat sleep disorders. Your doctor can prescribe the appropriate medication for your particular sleep problems.
- Anti-Parkinsonian drugs (dopamine agonists), such as gabapentin enacarbil (Horizant), pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro). These drugs may be used to treat restless legs syndrome and periodic limb movement disorder (also called nocturnal myoclonus syndrome).
- Benzodiazepines, which are included in a class of drugs called hypnotics. Examples include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Diastat, Valium), estazolam (Prosom), orazepam (Ativan), temazepam (Restoril), and triazolam (Halcion). These drugs may be used to treat parasomnias. Occasionally, they are also used to treat bruxism (teeth grinding) and short-term insomnia. These older sleeping pills may be useful when you want an insomnia medication that stays in the system longer. These medications have some serious downsides. They can cause addiction and dependence. Dependence means that you have physical withdrawal when you stop them. Also, there is a black box warning against their use with opioids because both depress breathing and increase your risk of overdose.
- Non-benzodiazepine hypnotics, such as eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo, Zolpimist). These drugs are used to treat short-term insomnia.
- A melatonin receptor stimulator, ramelteon (Rozerem), which is in a class by itself. It is used to treat insomnia.
- Anticonvulsants, such as carbamazepine (Carbatrol, Epitol, Tegretol), gabapentin (Neurontin), gabapentin enacarbil (Horizant), pregabalin (Lyrica), and valproate (Depakene, Depakote, Depakon). These drugs may be used to treat nocturnal eating syndrome, restless legs syndrome, periodic limb movement disorder, and insomnia related to bipolar disorder.
- Antinarcoleptics, such as methylphenidate (Ritalin) and modafinil (Provigil), can be used to improve daytime wakefulness in those who are shift workers or have narcolepsy or sleep apnea. Pitolisant (Wakix) and sodium oxybate (Xyrem, Xywav) are other drugs that can control excessive daytime sleepiness and loss of muscle control in people with narcolepsy.
- Antidepressants or antianxiety medications. Certain drugs used to treat anxiety and depression may be used for sleep because drowsiness is one of their main side effects. These include medications such as mirtazepine (Remeron), quetiapine (Seroquel), and trazodone(Desyrel).
- Orexin receptor antagonists. Orexins are chemicals that are involved in regulating the sleep-wake cycle and play a role in keeping people awake. This type of drug alters the action of orexin in the brain. These include daridorexant (Quviviq), lemborexant (Dayvigo) and suvorexant (Belsomra).
- 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 7 or 8 hours of sleep.
- 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. But if you're taking other drugs that also contain antihistamines -- like cold or allergy medications -- you could inadvertently take too much.
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." They also warned people that taking sleeping medication at night can impair their ability to drive or be fully alert -- even the next day.
Keep in mind that sleep drugs are not for long-term use. Talk to your doctor if you’re still having trouble sleeping after 2 weeks.