Should You Treat Chronic Insomnia with Medication?

Medications that help treat chronic insomnia include Ambien, anti-anxiety drugs, and OTC medications. These treatments are intended for short-term use and may have dangerous side effects.

Share on Pinterest Antonio_Diaz/Getty Images

Chronic insomnia is a sleep disorder characterized by recurring difficulties falling or staying asleep. Treating chronic insomnia with medication is one way to re-establish healthy sleep patterns. But vitamins, supplements, and alternative treatments can also help.

Insomnia is considered chronic if it continues for more than 3 nights per week for at least 3 months.

The first treatment for insomnia is usually changing your sleep habits, for example, trying to get to bed at the same time every night. Doctors typically prescribe medication as a last resort. And even then, most are intended for short-term use.

Read on to learn more about medications for chronic insomnia, including how they’re used, their effectiveness, and side effects.

Over-the-counter sleep medications

Over-the-counter medications used to treat insomnia include:

Products that contain antihistamines

Certain antihistamines used to treat allergies are sometimes used off-label to treat insomnia. This is because drowsiness is an expected side effect. Using a medication “Off-label” means using medications approved by the Food and Drug Administration (FDA) to treat a condition other than the one they were approved to treat (in this case, allergies).

It’s important to talk with a doctor before taking antihistamines for insomnia. They’re often not recommended because tolerance to their sedative effects tends to develop quickly. They can also cause symptoms such as daytime drowsiness or agitation.

Learn more about antihistamines for sleep.

Melatonin supplements

Melatonin is a hormone produced by your pineal gland. It helps regulate your body’s sleep-wake cycles. Melatonin supplements contain a synthetic version of this hormone.

Research hasn’t found melatonin supplements to be effective at treating insomnia, but they may be helpful in certain cases. Research suggests that melatonin may be effective at reducing jet lag when changing time zones.

Melatonin is available in doses from 0.5–10 milligrams (mg). It’s generally considered safe but may cause some side effects, such as nausea, headaches, and dizziness.

Learn more about melatonin.

Prescription sleep medications

Prescription medications used to treat insomnia include the following.

Benzodiazepines

Benzodiazepines are anti-anxiety medications that promote relaxation and drowsiness. But they have a high risk of dependence and can cause withdrawal symptoms when you stop taking them after long-term use. Doctors generally only recommend taking them for about 7–10 days.

Some types of benzodiazepines a doctor may prescribe include:

Medication	Quazepam	Triazolam	Estazolam	Temazepam
Brand names	Doral	Halcion	Prosom	Restoril
Dose (mg)	7.5 before bed	0.25 before bed	1 at bedtime	10–20

Benzodiazepine receptor agonist

Benzodiazepine receptor agonists tend to work faster than benzodiazepines and generally have a better side effect profile. These include:

Medication	Zolpidem	Zaleplon	Eszopiclone
Brand names	• Ambien• Edluar• Intermezzo• Zolpimist	Sonata	Lunesta
Dose (mg)	5 for females and 5–10 for males, immediately before bed	10 before bed	1–3 before bed

Orexin receptor antagonist

Orexin receptor antagonists block the effect of orexin, a neurotransmitter that stimulates wakefulness. These medications are usually not recommended for long-term use. Orexin receptor antagonists that are FDA approved in the United States include:

Medication	Belsomra	Lemborexant	Daridorexant
Brand names	Suvorexant	Dayvigo	Quiviviq
Dose (mg)	10 within 30 min of bed	5 before bed	25–50 before bed

Tasimelteon

Tasimelteon (Hetlioz) works by increasing the effect of melatonin on your brain. It’s FDA approved to treat sleep-wake disorders and Smith-Magenis syndrome. The recommended dose is 20 mg an hour before bed.

Doxepin

Doxepin (Silenor) works by blocking histamine and other receptors in your brain. For treating insomnia, the recommended dose is 3–6 mg before bed.

Natural supplements

Many natural supplement supplements are marketed for treating insomnia. The levels of evidence to support their use are mixed.

Supplement	Description	Usual dose
Valerian root	an herb native to Asia and Europe	300–600 mg
Magnesium	an essential mineral	under 350 mg
Lavender oil	an extract from the lavender flower	aromatherapy
Passionflower	a flower grown around the world	taken as a tea
Glycine	an amino acid	around 3,000 mg
CBD oil	a nonpsychoactive extract from hemp	variable

Learn more about natural treatments for insomnia.

Nonmedication treatment options

If improving your sleep habits alone doesn’t cure your insomnia, a doctor may recommend cognitive behavioral therapy for insomnia (CBT-I). CBT-I is a 6–8 week therapy.

Doctors often recommend CBT-I before trying medications for insomnia. During this type of therapy, you attend therapy sessions in where you may learn:

to employ relaxation techniques

to identify and end ineffective habits

to reduce sleep-related worry

Learn more about cognitive behavioral therapy for insomnia (CBT-I).

Home remedies for insomnia

Some ways you may be able to treat insomnia at home include trying to:

make sure your bedroom is cool and dark

avoid looking at electronics before bed

go to bed and wake up around the same time each day

avoid caffeine, alcohol, and nicotine close to bed

get regular physical activity

avoid napping throughout the day

minimize stress

Learn more about home remedies for insomnia.

When to talk with a doctor

Chronic insomnia can be very disruptive to your life. It’s a good idea to talk with a doctor if you have persistent symptoms that don’t respond to changing your sleep habits, such as:

trouble falling asleep

an inability to stay asleep

waking up earlier than you want to

not feeling refreshed after sleeping

feeling excessively sleepy during the day

Read about tips for talking with a doctor about insomnia.

Takeaway

The first treatment doctors recommend for chronic insomnia is usually making improvements in your sleep habits. Doctors may recommend medications if these changes, and a type of therapy called “CBT-I,” don’t relieve your symptoms. Some sleep-promoting medications, such as benzodiazepines, can have serious side effects and aren’t intended for long-term use.

Posted : 2024-09-30 09:08

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.