To Sleep, Perchance to Sleep Soundly (cont.)

The older classes of sleep medications, particularly the benzodiazepines -- think Valium and Xanax -- do more than just help you sleep. They affect how you sleep, altering your actual "sleep architecture," says Donna Arand, PhD, clinical director of the Kettering Sleep Disorders Center in Kettering, Ohio.

"They tend to decrease the amount of time spent in certain stages of sleep, particularly stages three and four (the deepest, most restful stages of sleep)," says Arand, who serves on the boards of the American Academy of Sleep Medicine and the American Insomnia Association. "People also complained of hangover effects from these medications." That's because they tend to have a longer "half-life," which is the length of time the drug stays in your body.

Non-benzodiazepine hypnotics like Ambien, Sonata, and Lunesta, however, share several advantages over previous generations of sleep drugs:

  • They have a relatively short half-life, so you won't wake up groggy the next day. "There are minimal reports of 'hangover' effects with these new drugs," says Arand.
  • They have little, if any, effect on sleep staging, allowing you the REM sleep you need. "You spend pretty close to the same amount of time in each stage of sleep as you would without the drugs," she says.
  • They are less likely than other sleeping pills to cause addiction, withdrawal symptoms, or a buildup of tolerance (when you require more and more drug to have the same effect).

Why? The newer medications act only on specific receptors in your brain that are focused on sleep, while older groups of drugs have a more generalized effect on multiple brain receptors. "These new drugs are among the safest medications in medicine," says Thomas Roth, MD, Director of the Sleep Disorders and Research Center at Henry Ford Health System in Detroit.

But they are not right for everyone. "If you have insomnia due to sleep-related breathing disorders [sleep apnea] or restless legs syndrome, for example, these drugs won't address your underlying problem," says Roth. Pregnant women, of course, shouldn't take these medications. And if you're "on call," frequently getting up in the middle of the night for work or for a child, they might not work for you.

Here, briefly, are the pros and cons of the new sleep medicines, as well as of the older medicines commonly used to treat insomnia:

Sonata: Of all the new sleeping pills, Sonata has shortest half-life, which is the amount of time it takes for the drug to be eliminated from your body. Its half-life is just one hour. That means you can try to fall asleep on your own. Then, if you're still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning.

Ambien: The most commonly prescribed sleeping pill, Ambien has a medium half-life. It's less than two-and-a-half hours. This means that Ambien is great for helping you get to sleep but, like Sonata, could be less helpful if you tend to wake up a lot in the middle of the night.