1. Insomnia Pictures Slideshow: 10 Tips to Avoid Insomnia
2. Sleep Slideshow: Foods That Help or Harm Your Sleep
3. Sleep Quiz: Test Your Medical IQ

Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is insomnia and what causes it?
• What are non-drug treatments for insomnia?
• Melatonin
• What over-the-counter (OTC) medicines are there for insomnia treatment?
• Antihistamines
• What prescription medicines are there for insomnia treatment?
• What stimulant products are available OTC?
• Caffeine
• Find a local Sleep Specialist in your town
• Sleep Aids And Stimulants Index

There are numerous prescription medications options a doctor may prescribe if a person is suffering from short-term or chronic insomnia. Most are not recommended for long-term use.

Medication to treat insomnia includes several classes of drugs;

• Short-acting sedative-hypnotics (non-benzodiazepines) - these medications slow activity in the brain to allow sleep.
  • zolpidem (Ambien, ZolpiMist)
  • Intermezzo was approved by the Food and Drug Administration in November 2011. It is a form of zolpidem, taken sublingually (dissolved under the tongue) and in smaller doses than Ambien.
  • zaleplon (Sonata)
  • eszopiclone (Lunesta)

In February 2007, the Food and Drug Administration issued a warning in regard to sedative-hypnotic drugs and their risks, which "...include severe allergic reactions and complex sleep-related behaviors, which may include sleep driving. Sleep driving is defined as driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event."

• Melatonin receptor agonists - used to help patients who have difficulty falling asleep and it works similarly to melatonin  
  • ramelteon (Rozerem): Ramelteon is a medication taken by mouth 30 minutes prior to bedtime. Ramelteon should not be taken if the patient will not be able to sleep for at least 7-8 hours. Insomnia usually improves in 7-10 days.
  • One of the advantages of ramelteon over other prescription sleep medications is the lack of dependence on the medication.
• Benzodiazepines (tranquilizers) - this class of medication is used to slow down the central nervous system, causing drowsiness. These medications have a high risk of dependence with chronic usage.  
  • flurazepam (Dalmane)
  • temazepam (Restoril)
  • estazolam (ProSom)
• Tricyclic antidepressants: Tricyclic antidepressants are medications work by increasing the amounts of certain natural substances in the brain that are needed for mental balance.
  • doxepin (Silenor): in 2010, this sleep medicine was approved for the use in people who have trouble staying asleep. Silenor may help with sleep maintenance by blocking histamine receptors.

If your doctor recommends prescription sleep medications:

• Follow all prescribing instructions given by your physician.
• Tell your doctor if you are taking any other medications or supplements you are taking as many can have adverse interactions with sleep medications.
• Tell your doctor about any pre-existing medical conditions.
• Note any possible negative side effects (changes in your body, and even your emotions)
• Do not use the medications nightly unless instructed to do so by a doctor - this can lead to dependence
• Avoid drinking alcohol or taking other non-prescription drugs while using sleep medication
• Never drive a car or operate machinery after taking a sleeping pill.