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- What is sleep?
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- What are the stages of sleep?
- How long does it take to get REM sleep?
- Why is REM sleep important?
- What percentage of sleep should be deep sleep?
- How much sleep does a person need?
- Does the amount of sleep we need change as we age?
- What are signs and symptoms of sleep deprivation?
- What are and what causes sleep disorders?
- How are sleep problems diagnosed?
- How are sleep problems treated?
- Sleep hygiene
- Other therapies
- Sleep aids (prescription and OTC)
- Are sleep problems and disease related?
- How can I get a good night's sleep?
Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More
Sleep aids (prescription and OTC)
Medications can be of value in treating some types of sleep disorders. However, since sedating medications typically have the potential for addiction and abuse, their use must be carefully supervised by a health care practitioner. Among the types of prescription drugs that have been prescribed for specific sleep disorders include:
- Benzodiazepines, such as triazolam (Halcion), temazepam (Restoril), and lorazepam (Ativan)
- Newer, non-benzodiazepine sedative drugs: zaleplon (Sonata), zolpidem (Ambien or Ambien CR, Zolpimist), and eszopiclone (Lunesta).
- Ramelteon (Rozerem), an insomnia drug that acts by mimicking the action of melatonin (see below)
- Suvorexant (Belsomra) is the first in a new class of drugs known as orexin receptor antagonists (ORAs for the treatment of insomnia. Suvorexant works by promoting the natural transition from wakefulness to sleep by inhibiting the wakefulness-promoting orexin neurons of the arousal system.
- Antidepressant medications have been used to treat insomnia in people who may also suffer from depression. Examples are trazodone (Desyrel), amitriptyline (Elavil, Endep), and doxepin (Sinequan, Adapin).
- A number of prescription drugs have been used to treat restless legs syndrome, including carbidopa-levodopa, opioids (such as propoxyphene [Darvon, Darvon-N, Dolene]) or tramadol (Ultram) for intermittent symptoms, carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol),clonazepam (Klonopin), diazepam (Valium, Diastat), triazolam (Halcion), temazepam (Restoril), baclofen, bromocriptine, clonidine (Catapres, Catapres-TTS, Jenloga), gabapentin (Neurontin), ropinirole (Requip) and pramipexole (Mirapex).
- In sleep apnea and other sleep disorders in which airway obstruction is a problem, topical nasal decongestants may provide some relief. However, many clinicians warn people with sleep apnea never to use sleeping pills or medications that are sedative as the person could be prevented from waking enough to stimulate breathing, which could lead to brain damage or sudden death.
OTC sleep medications are sometimes used for the short-term treatment of insomnia. These include the sedating antihistamines such as diphenhydramine (Benadryl). However, this is not a recommended use of these or other similar drugs due to their many side effects and the possibility of long-term drowsiness the following day.
Melatonin, a chemical released from the brain which induces sleep, has been tried in supplement form and promoted as a natural sleep remedy for treatment of insomnia. But studies have shown that it has been generally ineffective in treating common types of insomnia, except in specific situations in patients with known low levels of melatonin.
CPAP devices (continuous positive airway pressure; a device worn over the face that holds the airway open by maintaining constant air pressure) or AutoPAP (PAP delivered over a range of pressures) and dental appliances have been effective in the management of sleep-related breathing disorders, including sleep apnea. CPAP is typically the first line of therapy for most adult patients with obstructive sleep apnea. Surgery can be effective for some patients and may help patients respond to CPAP. Newer, implantable devices that stimulate the muscles of the upper airway during sleep may also be a treatment option for some patients.