Insomnia is a common sleep disorder that people associate with trouble falling asleep, waking in the middle of sleep, or not getting a restful sleep. Some medications may help someone with chronic insomnia, but a person should exercise caution when using them for a long period.

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Several prescription sleep aids can help with infrequent bouts of insomnia. Some medications, such as benzodiazepines, can help with short-term or acute insomnia. While they can prove effective in treating insomnia, a person needs to avoid using them in the long term and only use them for a few weeks due to potential dependency issues.

Other sleep aids may help with long-term insomnia. Benzodiazepine receptor agonists may be safe to take for long periods. These are prescription medications that include prescription strength zaleplon (Sonata), zolpidem (Ambien), and eszopiclone (Lunesta).

A person may also find that some over-the-counter or off-label medications or supplements may help with chronic insomnia.

Before taking any medication or supplement, a person needs to discuss their use with a doctor. Some medications may interact with others or cause other unwanted side effects. Generally, individuals should only take sleep aids when necessary. They also need to make other lifestyle changes to help them fall asleep.

This article reviews some of the best sleep aid options for people with chronic insomnia.

Zaleplon, available as both a generic medication and branded medication, Sonata, is a type of benzodiazepine receptor agonist. It can help induce a sleepy feeling in people who take it.

According to the Food and Drug Administration (FDA), several studies have looked at the effectiveness of zaleplon for long-term use. They noted sleep latency was about 10–20 minutes less when using the medication. Sleep latency refers to the time it takes for someone to fall asleep after turning the lights out.

However, they also noted several potential side effects, which included mental impairment, anxiety from withdrawal, and sedative effects, among others.

A person needs a prescription to get zaleplon and should only use it as a doctor has prescribed. It is available in 5- and 10-milligram (mg) capsules. Health experts recommend tapering off the medication slowly and under the guidance of a healthcare professional to avoid withdrawal effects.

Zolpidem is available as both a name brand (Ambien) and generic prescription medication.

Evidence from a 2018 study suggests that the effectiveness of Ambien tends to decrease after 14 days, while continued use increases the likeliness of dependency and adverse effects. While more research is necessary, some evidence suggests that the potential risks from long-term use may include cognitive deficits and dementia.

Combining Ambien with other sleep medications or alcohol could increase the likelihood of developing adverse effects. A person should take the medication only as a doctor prescribes. They should also consult a doctor about appropriate use.

A person may find that intermittent use may help with chronic insomnia. In other words, they may find that taking it occasionally for an acute bout of insomnia may help, but they need to stop using it after 4 weeks to prevent dependence.

Lunesta, the brand name for eszopiclone, is another prescription medication doctors recommend for treating insomnia. However, the medication can become habit-forming and addictive.

People who do not plan to get at least 7 hours of sleep or intend to use alcohol should avoid taking Lunesta. Adverse effects can include recurrent headaches, dry mouth, and persistent fatigue, among others.

Individuals should also discuss the use of Lunesta with a doctor and follow their instructions for use. While a person should not use it continuously, occasional use and only when necessary may help someone with insomnia fall asleep.

Melatonin is a hormone that the body releases naturally to help with falling asleep. While melatonin in supplement form may help some people, long-term and large studies have not fully proven it is effective in treating insomnia.

A person may find that taking melatonin supplements may help them fall asleep. However, they should discuss its use with a doctor.

Additionally, this lab-made hormone can cause side effects that include:

  • daytime sleepiness
  • headaches
  • changes to blood pressure
  • upset stomach
  • worsening depression

Before using melatonin, a person should keep in mind that the FDA considers it a dietary supplement and therefore does not regulate melatonin the same way it does medications. As a result, the potency, dose, and safety of medications may vary between brands.

CBT-I can often help people with insomnia fall asleep and get better quality sleep. It is the first long-term treatment option for insomnia and involves working with a therapist, doctor, nurse, or other professional.

CBT-I involves several parts, including:

  • Cognitive therapy: Helps with nervousness about not being able to sleep.
  • Relaxation or meditation therapy: Teaches a person how to relax and fall asleep faster.
  • Sleep education: Helps someone learn good sleep habits.
  • Sleep restriction therapy: Provides a specific amount of time to spend in bed with or without sleep.
  • Stimulus control therapy: Helps link the sleep-wake cycle to help the association between being asleep with being in bed.

While certain medications or supplements may help with insomnia, most require a person to only take them sporadically. While this may work for occasional insomnia, it may not be as helpful for someone who continues to have trouble sleeping after a few weeks of use.

Alongside sleep aids, individuals may find that lifestyle and sleep hygiene changes may help.

According to a 2020 study of over 400 people, researchers found a correlation between insomnia and sleep hygiene issues. They found that improving sleep hygiene helped improve sleep quality and wakefulness during the day.

To help improve sleep, the Centers for Disease Control and Prevention (CDC) recommend the following steps to improve sleep:

  • going to bed and waking up at the same time every day, including on weekends
  • avoiding alcohol, caffeine, or large meals before bedtime
  • removing electronic devices from the bedroom
  • using the bed only for sleep and sexual activities
  • making the bedroom dark, cool, and relaxing

Other ways to improve sleep include:

  • getting regular physical exercise at least 5 to 6 hours before bedtime
  • trying not to nap during the day
  • learning and practicing new ways to manage stress

These changes, with the occasional use of medication, may help improve a person’s overall insomnia symptoms and help them get better sleep more consistently.

Sleep aids generally have the potential to cause potentially serious side effects. Many can lead to misuse or addiction if people use them for longer than a few weeks at a time.

A person can discuss their concerns with a doctor and follow their recommendations on how frequently they can take medication to help with sleep.

Individuals may find better long-term treatments for insomnia through CBT-I. They also may find that their sleep improves with lifestyle changes and improvements to their sleep hygiene.

Sleep aids can generally help with sporadic insomnia. While people may use some over the long term, in most cases, recommendations state to use them for up to a few weeks at a time. A person should use sleep aids only when necessary and discuss their use with a doctor.

In addition to sleep aids, a person may find that CBT-I, lifestyle changes, and improving sleep hygiene may work better for the long-term treatment of insomnia. They can then use sleep aids as necessary to help with acute episodes of insomnia.