Insomnia Treatment: Sleep Aids and Stimulants

Medical Author: John P. Cunha, DO
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

• What is insomnia and what causes it?
• What are non-drug treatments for insomnia?
• What over-the-counter (OTC) medicines are there for insomnia treatment?
• Antihistamines
• Melatonin
• What prescription medicines are there for insomnia treatment?
• What stimulant products are available OTC?
• Caffeine

What is insomnia and what causes it?

Insomnia is difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are:

• medications,
  
  
• psychological conditions (for example, depression, anxiety),
  
  
• environmental changes (for example, travel, jet lag, or altitude changes), and
  
  
• stressful events.

Insomnia can also be caused by faulty sleeping habits such as excessive daytime naps or caffeine consumption.

Insomnia may be classified by how long the symptoms are present.

• Transient insomnia usually is due to situational changes such as travel, extreme climate changes, and stressful events. It lasts for less than a week or until the stressful event is resolved.
  
  
• Short-term insomnia usually is due to ongoing stressful events, medication side effects, medical conditions, and lasts for one to three weeks
  
  
• Chronic insomnia (long-term insomnia) often results from depression or substance abuse and continues for more than three weeks.

Transient insomnia may progress to short-term insomnia and without adequate treatment, short-term insomnia may become chronic insomnia.

Among the medications and substances that can contribute to insomnia are:

• caffeine and coffee,
  
  
• tobacco,
  
  
• alcohol,
  
  
• decongestants (for example, pseudoephedrine),
  
  
• diuretics [for example, furosemide (Lasix), hydrochlorothiazide (Dyazide)] especially if taken in the evening or at bedtime,
  
  
• antidepressants [for example, bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban), fluoxetine (Prozac)],
  
  
• appetite suppressants [for example, sibutramine (Meridia), phentermine (Fastin)], and
  
  
• amphetamines.

Insomnia also may be the result of withdrawal from:

• benzodiazepines [for example, diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan)],
  
  
• alcohol,
  
  
• antihistamines,
  
  
• amphetamines,
  
  
• cocaine,
  
  
• marijuana, and
  
  
• other addicting drugs.

Next: What are non-drug treatments for insomnia? »

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