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Types of Insomnia Medications: Picking the Right One

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Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient's unique health circumstances and needs.

If you’ve tried natural insomnia treatments, such as dietary and lifestyle modifications or improved sleep hygiene, but nothing has worked, you might want to consider sleep medications. When taking prescription sleeping pills, you usually notice their effect fast, but there are some crucial considerations as well.

First of all, there are many types of sleeping aids, and medical help is needed when choosing the best one. Second, not all sleeping pills are suitable for long-term use because of dependence risks. Third, there are various side effects associated with sleep medications, so the doctor should monitor your treatment progress.

The above-mentioned and other aspects make it important to consult a doctor when choosing insomnia medications. Still, it can be beneficial to know the pros and cons of different drug types in advance. Read on to learn more!

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Insomnia as a Medical Condition

Insomnia is among the most common sleep issues. It can make it difficult to fall asleep, stay asleep, or get a good night’s sleep, even if you have the time and the ideal atmosphere. Insomnia may also cause daytime sleepiness, which may hinder your everyday tasks.

There are many potential reasons for insomnia. Aside from environmental factors and stress, this disorder has a complicated cause-and-effect relationship with other health issues. It can worsen them or cause them to flare up. Another common cause of insomnia is hyperarousal, which can be mental or physical. Hyperarousal can be triggered by various environmental circumstances and medical problems, such as fears and anxiety.

Long-term insomnia treatment usually involves identifying the cause of the condition and learning to deal with it. But as the first step, doctors may prescribe medications to help lessen the symptoms. It helps a person get back to normal functioning due to restful sleep. But what medication types treat sleep issues? These are reviewed below.

Commonly Prescribed Insomnia Medications

All prescription drugs must be approved by the Food and Drug Administration (FDA) before they become available in pharmacies to the public. Even over-the-counter (OTC) medications must meet FDA standards. To make conclusions, the FDA carefully examines data from research studies about the drug’s efficacy and safety. It can approve a drug for treating a specific condition, but sometimes the same medication can be prescribed off-label for another disorder as well.

Below are some common prescription sleep aids and OTC medications that may be prescribed to treat insomnia.

Sedative-Hypnotics

They are a class of medications that inhibit brain activity and, at higher doses, cause sedation, sleep, and unconsciousness. Here are some common examples.

Non-Benzodiazepine sedative-hypnotics

These are relatively newer sedative medications also known as ‘Z drugs’. This class includes:

Ambien

It is an effective FDA-approved drug for the short-term treatment of severe insomnia. Generic name for Ambien is zolpidem [1*] . It is available in the form of tablets and by prescription only. It is generally well tolerated. Zolpidem enhances the effect of gamma-aminobutyric acid (GABA), a sedative neurotransmitter found in the brain. It helps the patient to fall asleep more easily and reduces the chances of waking up in the middle of the night.

Sonata

Zaleplon [2*]  (Sonata) assists patients in falling asleep. It helps to feel sleepy and drowsy by acting on the GABA receptors in your brain. You should only take it for short-term treatment and shortly before night because it takes effect quickly.

Lunesta

Eszopiclone [3*] is a drug used to treat insomnia and is marketed under the trade names Lunesta and others. In order to promote sleep, it slows down brain activity. It might make it easier for you to go to sleep, stay asleep for longer, and wake up less frequently at night so you can enjoy a better night’s sleep.

Benzodiazepines

Benzos are more traditional medications for insomnia. In the past, they have been successfully used to treat sleep disorders such as sleepwalking and night terrors. These drugs have major drawbacks, such as residual daytime sleepiness, rebound insomnia, and difficulty forming new memories, and can lead to addiction and dependency. Examples of benzos used for insomnia include Temazepam (Restoril) and Triazolam (Halcion), which may be helpful if you need a longer-lasting insomnia treatment.

Sleep medications

Orexin receptor antagonists

Dayvigo

Lemborexant (Dayvigo [4*] ) is used for treating insomnia in adults by improving sleep onset and maintenance. It blocks orexin signals in the brain, which are believed to play a role in wakefulness. These medicines slow down the nervous system and help to get to sleep faster and sleep throughout the night.

Belsomra

Suvorexant (Belsomra) is approved to treat insomnia. It prevents the binding of neuropeptides (orexin A and B) that support wakefulness, unlike other hypnotics.

Quviviq

A drug called daridorexant, marketed under the trade name Quviviq, is another orexin antagonist. It functions by inhibiting the activity of orexin, a brain chemical that encourages alertness. Quviviq accomplishes this by binding to two different orexin receptors (targets). Quviviq, then, aids individuals in falling asleep more rapidly, staying asleep for longer, and enhancing daytime performance.

Melatonin receptor agonists

Rozerem

Ramelteon (Rozerem [5*] ) is the first of a new class of sleep medications known as melatonin agonists. These drugs bind specifically to the melatonin receptors located in the suprachiasmatic nucleus (SCN) to regulate the sleep-wake cycle, promoting sleep. It helps with insomnia characterized by delayed sleep onset. Ramelteon has not been proven to cause dependence and has not demonstrated any misuse potential.

Hetlioz

The American Food and Drug Administration has approved the drug tasimelteon [6*] , marketed under the trade name Hetlioz. Similar to other members of the melatonin receptor agonist class, including ramelteon, tasimelteon is a selective agonist for the MT1 and MT2 melatonin receptors. The patient may experience better sleep timing while taking the medication to cure their insomnia.

Get a detailed personalized treatment plan for insomnia from a licensed doctor.

Antidepressants

These medications for insomnia were initially intended to treat depression but were later discovered to have sedative properties. The FDA has officially approved only one antidepressant (Doxepin) for insomnia. Doxepin is a tricyclic antidepressant sold under the trade name Silenor. Doctors may advise insomniacs to take it 30 minutes before bedtime for up to three months. It might aid in sleep onset and maintenance. Silenor is not recommended for those using monoamine oxidase inhibitors (another class of antidepressants) and those with glaucoma or urinary retention.

Over-the-counter (OTC) Medications for Insomnia

Other types of sleep aids that are available without a prescription and can treat insomnia and other sleep issues are known as over-the-counter meds. But before using these medications for the first time, you should speak to a doctor about risk factors, side effects, and other potential concerns. Some examples of OTC medications include:

  • Melatonin. The body produces the hormone melatonin that controls the sleep-wake cycle. Most melatonin supplements are produced in a laboratory. It is used to treat insomnia and promote restful sleep [7*] under various circumstances, including jet lag.
  • Antihistamines. Antihistamines can cause sedation by inhibiting H1 receptors in the central nervous system and are typically used to treat the symptoms of hay fever or other allergies. Diphenhydramine [8*] , compared to other antihistamines, acts as a drowsy (sedating) antihistamine and is more likely to induce sleep. Doxylamine [9*] , another antihistamine, used to treat symptoms of a common cold, is also useful in relieving insomnia in the short term.
  • Valerian. It is a herbal product derived from the plant’s root that serves a variety of functions. It is a sedative, which may be beneficial for insomnia treatment. However, its effectiveness is inconclusive [10*] for this purpose.

Pros and Cons of Sleeping Meds

Benefits: improved sleep quality, higher nighttime sleep efficiency, and a more regular sleep pattern. Also, better sleep can lessen daytime tiredness, and improved sleeping patterns contribute to gaining healthy habits.

Adverse effects: the potential drawbacks of sleep aids differ depending on the particular prescription and individual specifics. These include:

  • Even if a sleep drug isn’t meant for long-term usage, a person can nevertheless develop a dependency on it.
  • After frequent use, abrupt cessation of the medication may increase sleep issues or withdrawal symptoms.
  • These medications may have a comparable overall impact on driving while intoxicated, impairing one’s attention, reaction time, and judgment.
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In Conclusion

Every sleep aid has possible advantages and disadvantages, so it’s critical to understand how they operate, what conditions they might treat, and safe usage practices. Working with a doctor who can suggest the best-sleeping pills depending on your circumstances is essential if you want to select the greatest insomnia medication.

Sources

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+10 sources
  1. Zolpidem. (2022)
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  2. Zaleplon. (2023)
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  3. Eszopiclone for insomnia. (2018)
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  4. Preclinical and clinical efficacy of orexin receptor antagonist Lemborexant (Dayvigo®) on insomnia patients. (2021)
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  5. Pharmacotherapy of Insomnia with Ramelteon: Safety, Efficacy and Clinical Applications. (2011)
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  6. Tasimelteon: first global approval. (2014)
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  7. Prolonged release melatonin in the treatment of primary insomnia: evaluation of the age cut-off for short- and long-term response. (2010)
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  8. Diphenhydramine
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  9. Histamine-1 receptor antagonism for treatment of insomnia. (2012)
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  10. Valerian for insomnia: a systematic review of randomized clinical trials. (2000)
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