Key takeaways

  • Prescription sleep medications include benzodiazepines, Z-drugs, and others like doxepin and ramelteon. Most are strictly for short-term use (7 to 10 days), while a few can be prescribed longer.
  • Many carry risks of dependency, next-day drowsiness, worsening depression, and complex sleep behaviors like sleep-driving. Additionally, benzodiazepines and Z-drugs have boxed warnings against combining with opioids due to risks of severe sedation, coma, and death.
  • Always consult a doctor about your medical history and interactions with other medications, alcohol, or supplements. If insomnia exceeds 7 to 10 days, seek medical advice to explore underlying causes and alternatives like cognitive behavioral therapy.

Sleep disturbances are common. An estimated 50 to 70 million people in the United States experience chronic sleep or wakefulness conditions, which are more common in females and older individuals.

A range of medications can help people fall asleep, stay asleep, or both. Prescription sleep aids can often relieve insomnia for short periods. However, many of these medications carry risks of side effects, misuse, and dependency.

Some sleep medications interact with other substances, including other medications, alcohol, and vitamin supplements. For this reason, you should consult a doctor before starting any new sleep medication.

Prescription sleep medications also carry high risks for people ages 65 years and older, such as an increased risk of falls, fractures, confusion, and memory problems. If you’re an older adult, talk with your doctor about safer alternatives for insomnia.

This article reviews 10 medications a doctor may prescribe to help you sleep. It also explores some nonmedical solutions for sleep issues.

Doxepin pros

  • helps maintain sleep
  • use for up to 3 months
  • two dose sizes (3 milligrams [mg] and 6mg)

Doxepin cons

  • may cause cognitive changes
  • not suitable to take with MAOIs
  • not suitable for people with glaucoma or urinary retention
  • not suitable while breastfeeding
  • not suitable for people with severe sleep apnea

Doctors may prescribe doxepin (Silenor), a type of tricyclic antidepressant, for up to 3 months for people with insomnia. It may help you stay asleep.

It is available as an immediate-release tablet in 3 mg and 6 mg doses. You should talk with a doctor about the best dose for your needs.

Doctors do not recommend doxepin for those taking monoamine oxidase inhibitors, a type of antidepressant, or people with glaucoma or urinary retention.

Doxepin may cause side effects in some people. These can include:

If you’re pregnant, consult a doctor before using Doxepin. Avoid taking it if you’re breastfeeding, as it can pass into breastmilk and cause serious adverse reactions.

It’s unknown whether doxepin is safe and effective to give to children, so avoid this unless directed by a medical professional.

Do not take this medication within 3 hours of a meal.

If symptoms do not clear within 7 to 10 days, contact a doctor. They may need to rule out other possible causes of insomnia.

Temazepam pros

  • short term treatment of insomnia (typically 7 to 10 days)
  • four dose sizes (7.5 mg, 15 mg, 22.5 mg, and 30 mg capsules)

Temazepam cons

  • side effects include headache, nausea, and dizziness
  • can cause dependency and addiction
  • not suitable to take at the same time as opioids (boxed warning)
  • not suitable during later stages of pregnancy

Temazepam, which has the brand name Restoril, is a benzodiazepine. This kind of medication may cause dependency and addiction if you misuse it.

Temazepam is available by prescription for the short-term treatment of insomnia. The typical prescription length is 7 to 10 days. A doctor will generally reassess you following this period to determine if an underlying cause is responsible for your insomnia.

Taking temazepam during the later stages of pregnancy carries risks for the fetus, so discuss this with your doctor if you’re considering taking it.

Temazepam has a boxed warning stating that it must not be used at the same time as opioids, which can lead to severe sedation, breathing problems, coma, and death.

Temazepam can cause a variety of side effects, which may include one or more of the following:

Temazepam comes in four dose sizes, ranging from 7.5 to 30 mg. You should talk with a doctor about the right dose for you.

Triazolam pros

  • short term treatment of insomnia (typically 7 to 10 days)
  • two dose sizes (0.25 mg and 0.5 mg)

Triazolam cons

  • may cause cognitive changes or worsening insomnia
  • can cause dependency and addiction
  • common side effects include impaired muscle coordination and dizziness
  • not suitable to take at the same time as opioids (boxed warning)

Doctors can prescribe triazolam (Halcion) for the short-term treatment of insomnia, typically for 7 to 10 days.

Like Temazepam, this medication is a benzodiazepine. Because the medication has the potential for dependency and misuse, doctors do not recommend it as a long-term treatment for insomnia.

Common side effects may include:

In some people, triazolam can cause:

  • complex sleep behaviors, such as sleepwalking
  • dependency
  • withdrawal symptoms when you suddenly stop taking it
  • worsening insomnia
  • CNS issues such as changes in behavior, unusual thinking, and anxiety
  • worsening depression
  • issues with performing activities such as driving

Triazolam comes in two dose sizes: 0.25 mg and 0.5 mg. You should not exceed 0.5 mg daily.

Ramelteon pros

  • helps with falling asleep
  • longer term use
  • low likelihood of misuse and dependency

Ramelteon cons

  • may not be suitable for people with a severe liver impairment
  • may cause dizziness, nausea, fatigue, or worsening insomnia
  • serious side effects include behavioral changes, worsening depression, and suicidal thoughts
  • may not be suitable during pregnancy

Ramelteon (Rozerem) is a melatonin agonist that may help you fall asleep. Melatonin is a naturally occurring substance in the body, and by affecting melatonin receptors, ramelteon promotes sleep and positively affects circadian rhythms.

Due to this, a doctor may prescribe ramelteon for longer-term use, unlike other medications that are indicated for short-term use.

This medication comes in a one-size dose of 8 mg. You should not exceed a single dose daily.

Unlike many other sleep aids, ramelteon is not a controlled substance. It has a low likelihood of misuse or dependency. However, it can still cause side effects such as:

  • drowsiness
  • dizziness
  • fatigue
  • nausea
  • worsening insomnia
  • complex sleep behaviors, such as sleepwalking
  • hallucinations
  • behavioral changes
  • worsening depression
  • suicidal thoughts

It can also cause allergic reactions in some people.

Other groups that should use caution in taking this medication may include those who:

  • are pregnant
  • have severe liver impairment
  • are taking the medication fluvoxamine
  • have had an allergic reaction to the medication in the past

Suvorexant pros

  • may help with falling asleep and staying asleep
  • two dose sizes (5 mg to 20 mg)

Suvorexant cons

  • may cause worsening mental health, complex sleep behaviors, and sleep paralysis
  • only available as a brand-name drug, so may be expensive
  • common side effects include next-day sleepiness, dry mouth, and diarrhea

Suvorexant (Belsomra) may help you fall asleep and maintain sleep. It is only available as a brand name medication.

Belsomra is a scheduled IV controlled substance that can cause CNS impairments that can lead to trouble with driving and other activities.

It can also cause:

  • worsening suicidal thoughts or depression
  • complex sleep behaviors, such as sleepwalking
  • sleep paralysis

Other potential side effects reported in clinical trials include:

A doctor may prescribe a 5 mg to 20 mg dose. Clinical trials showed that higher doses could lead to more adverse reactions.

Trazodone pros

  • may help with falling asleep
  • four dose sizes (50 mg, 100 mg, 150 mg and 300 mg)

Trazodone cons

  • can increase the effects of alcohol
  • common side effects include edema, blurred vision, and fainting
  • not suitable alongside other drugs that increase bleeding risk and MAOIs
  • not suitable for people with angle closure glaucoma or certain heart conditions

Trazodone is a medication that modulates the neurotransmitter serotonin. Doctors typically use it to treat major depressive disorder. However, they may prescribe it off-label to help you fall asleep since one of its effects is drowsiness.

Doctors may prescribe 50 mg to 100 mg of trazodone for insomnia. For depression, the dose is higher, typically starting at 150 mg.

Though they may be less likely at these lower doses, this medication can still cause side effects such as:

You may have a higher risk of bleeding when you take trazodone alongside the following drugs:

People should limit their alcohol consumption when taking trazodone, as it can increase the effects of alcohol.

Trazodone is not suitable for people with certain heart conditions, angle closure glaucoma, or those taking MAOIs.

Estazolam pros

  • short term treatment
  • two dose sizes (1 mg or 2 mg)

Estazolam cons

  • stopping suddenly may cause dangerous withdrawal reactions
  • risk of misuse and dependency
  • common side effects include loss of coordination, drowsiness, and impaired movements
  • not suitable to take alongside opioids

Doctors can prescribe estazolam for the short-term treatment of insomnia. It may help with falling and staying asleep.

Estazolam is a benzodiazepine and has a risk of misuse and dependency. Doctors typically prescribe it for short-term help with insomnia.

A doctor may prescribe 1 mg or 2 mg tablets for insomnia treatment.

Estazolam can cause reactions such as:

  • loss of coordination
  • drowsiness
  • hypokinesia, or a reduced range of movements
  • dizziness
  • complex sleep behaviors, such as sleepwalking

Estazolom has a boxed warning for the following risks:

  • using it at the same time as opioids can lead to severe sedation, breathing problems, coma, and death
  • abruptly stopping estazolam or rapidly reducing the dosage can lead to dangerous withdrawal reactions, such as seizures

Eszopiclone pros

  • may help with falling asleep and staying asleep
  • three dose sizes (1 mg, 2 mg, and 3 mg)

Eszopiclone cons

  • stopping abruptly can lead to withdrawal symptoms
  • risk of misuse and dependency
  • common side effects include respiratory infections, dizziness, and an unpleasant taste in the mouth

Eszopiclone (Lunesta) may help you fall asleep and stay asleep.

Eszopiclone is part of a drug family known as Z-drugs. These are schedule IV controlled substances that carry a risk of misuse and dependency.

Though generally safe, reported side effects include:

In addition, eszopiclone may cause you to engage in complex sleep behaviors, such as sleepwalking or driving while asleep. You should discontinue use and tell their doctor if they experience these behaviors.

Parents and guardians should talk with a doctor before giving this medication to children or adolescents. Pregnant people should also consult a doctor before taking it.

The recommended starting dose for eszopiclone is 1 mg. A doctor can increase this to 2 or 3 mg if needed.

Other precautions you should be aware of before taking eszopiclone include the following:

  • Safety: Higher doses can impair your CNS even when awake, making driving and other complex tasks more dangerous.
  • Age: Older people should avoid taking higher doses.
  • Mental health: Eszopiclone may worsen depression or suicidal thoughts.
  • Allergies: It can cause allergic reactions in some people, ranging from mild to severe.

Stopping eszopiclone suddenly or rapidly reducing your dose can lead to withdrawal reactions such as anxiety, abnormal dreams, and nausea.

Zaleplon pros

  • short term treatment
  • may help with falling asleep but not with staying asleep
  • two dose sizes (5 mg and 10 mg capsules)

Zaleplon cons

  • not suitable to take alongside alcohol or opioids
  • risk of dependency and misuse
  • common side effects include drowsiness, dizziness, and diarrhea
  • may cause complex sleep behaviors, such as sleep-driving and sleepwalking

Zaleplon (Sonata) may be useful for the short-term treatment of insomnia. While it may help you fall asleep, it does not help maintain sleep. Like eszopiclone, this is a Z-drug.

Taking zaleplon carries a risk of dependency. It also has a high likelihood of misuse.

A typical adult dose is 10 mg, though some may find that 5 mg is sufficient. Doctors may also prescribe 20 mg in some cases.

Zaleplon can cause a variety of side effects, including:

  • drowsiness
  • dizziness
  • diarrhea
  • difficulty concentrating
  • hallucinations
  • mood changes
  • memory loss

Zaleplon has a boxed warning for complex sleep behaviors, such as sleep-driving and sleepwalking.

You must avoid alcohol, opioids, and other drugs that slow brain activity while taking zaleplon. This is because it can increase the risk of slowed brain activity and reduced reaction times.

Zolpidem pros

  • short term treatment
  • available as immediate-release and extended-release tablets

Zolpidem cons

  • risk of dependency
  • may not be suitable for people with liver impairment and breathing problems
  • may cause complex sleep behaviors and other serious side effects
  • not suitable during pregnancy

Zolpidem, which has the brand names Ambien, Intermezzo, and Zolpimist, is a sleep medication that may help with falling asleep and sleep maintenance. It is another Z-drug.

Zolpidem is available in a once-daily 12.5 mg extended-release tablet and 5 mg and 10 mg immediate release tablets. When prescribing immediate-release zolpidem medications, they will often start with the lowest possible dose and work upward.

Because women clear Zolpidem from their systems more slowly, the FDA recommends an initial dose of:

  • Immediate relase: 5 mg for women and 5mg to 10 mg for men
  • Extended release: 6.25 mg for women and a single dose of 6.25 mg or 12.5 mg for men

Doctors do not recommend you take zolpidem during pregnancy or if you have impaired respiratory function.

Zolpidem is also not suitable for people with severe liver impairment. People with mild-to-moderate liver impairment may require a lower dose.

Common side effects may include:

  • dizziness
  • headache
  • next-day sleepiness

When taking zolpidem-containing drugs, drowsiness and lack of alertness in the morning can result from persistently high levels of the drug in the blood. As a result, activities that require focus and alertness, such as driving, may not be advisable for those taking high doses.

Like some other sleep medications, it may cause complex sleep behaviors. It can also lead to anaphylactic reactions, CNS depression, worsening depression, risk of dependency, and withdrawal effects in some people.

Though medications may help some people with insomnia, other remedies may also help you sleep better. You may wish to try the following home remedies:

Resources for healthy sleep

To discover more evidence-based information and resources on the science of healthy sleep, visit our dedicated hub.

Medications for sleep can provide short-term relief from insomnia.

However, many of these medications have potentially serious side effects, including complex sleep behaviors. Some sleep medications may pose a risk of dependency and misuse.

You should talk with a doctor before and while using any sleep aid. Tell them about other substances you use and any side effects you experience.

Disclaimer: While Medical News Today strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.