Various medications can help people fall asleep, stay asleep, or both, such as doxepin (Silenor) and Ramelteon (Rozerem). But, there may be some risks and side effects. Several are only for short-term use.
This article reviews 10 of the best medications a doctor may prescribe to help a person sleep. It also explores some nonmedical solutions for sleep issues.
Sleep disturbances are common. An estimated
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, a person should consult a doctor before starting any new sleep medication.
Doxepin is a sleep aid with the brand name Silenor. Doctors may suggest people with insomnia use Silenor for up to 3 months. It may help a person fall asleep and stay asleep.
It is available as an immediate-release tablet in 3 and 6 milligram (mg) doses. A person should talk with a doctor about the best dose for their needs.
Silenor may cause side effects in some people. These can include:
- central nervous system (CNS) depression, where brain activity slows
- worsening depression or suicidal thoughts
- unusual thinking patterns and behavior changes
People who are pregnant or nursing should consult a doctor before using Silenor. Parents or caregivers should only give it to children or adolescents if directed by a medical professional.
If symptoms do not clear within 7–10 days, a person should contact a doctor. They may need to rule out other possible causes of insomnia.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Restoril is available by prescription for the short-term treatment of insomnia. The typical prescription length is 7–10 days. A doctor will generally reassess the person following this period to determine if an underlying cause is responsible for their insomnia.
People who are pregnant should not take Restoril.
Restoril can cause a variety of side effects, which may include one or more of the following:
- dry mouth
Restoril comes in a variety of dosages, ranging from 7.5 to 30 mg. A person should talk with a doctor about the right dose for them.
Eszopiclone (Lunesta) may help a person fall and stay asleep.
Lunesta is a controlled substance with a tendency to lead to misuse and dependency. A person may also experience diminishing effects or increased tolerance to the medication over time.
Though generally safe, reported side effects include:
In addition, Lunesta may cause a person to engage in complex sleep behaviors, such as sleepwalking or driving while asleep. A person 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 Lunesta is 1 mg. A doctor can increase this to 2 or 3 mg if needed.
Other precautions a person should be aware of before taking Lunesta include the following:
- Safety: Higher doses can impair a person’s CNS even when awake, making driving and other complex tasks more dangerous.
- Liver function: People with reduced liver function should avoid taking Lunesta.
- Age: Older people should avoid taking higher doses.
- Mental health: Lunesta may worsen depression or suicidal thoughts.
- Allergies: It can cause an allergic reaction in some people.
Ramelteon (Rozerem) may help a person fall asleep. Unlike other medications, a doctor may prescribe Rozerem for longer-term use.
This medication comes in a one-size dose of 8 mg. A person should not exceed a single dose daily.
Unlike many other sleep aids, Rozerem is not a controlled substance. It has a low likelihood of misuse or dependency. However, it can still cause side effects such as:
- worsening insomnia
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 (Belsomra) may help a person fall asleep and maintain sleep.
A person taking Belsomra has a risk of misusing the medication and developing dependency. Like other controlled substances, it 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
- sleep paralysis
Other potential side effects reported in clinical trials include:
A doctor may prescribe a 5–20mg dose. Clinical trials showed that higher doses could lead to more adverse reactions.
Doctors can prescribe triazolam (Halcion) for the short-term treatment of insomnia, typically for 7–10 days.
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, Halcion can cause:
- complex sleep behaviors
- withdrawal symptoms when a person suddenly stops taking it
- worsening insomnia
- CNS issues such as changes in behavior, unusual thinking, and anxiety
- worsening depression
- issues with performing activities such as driving
It comes in two dose sizes: 0.25 mg and 0.5 mg. A person should not exceed 0.5 mg daily.
Trazodone (Desyrel) 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 a person fall asleep since one of its effects is drowsiness.
The typical starting dose is 150 mg daily, divided into two doses. Doctors may increase this to a maximum daily dose of 400 mg.
However, a doctor will likely prescribe a lower amount for sleep disturbances. A
Though they may be less likely at these lower doses, this medication can still cause side effects such as:
- edema, where the tissues of the body contain too much fluid
- blurred vision
- weight loss
- nasal congestion
It may also increase thoughts of suicide.
People should limit their alcohol consumption when taking Desyrel, as it can increase the effects of alcohol.
Doctors can prescribe estazolam (Prosom) for the short-term treatment of insomnia. It may help with falling and staying asleep.
Prosom 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
- hypokinesia, or a reduced range of movements
Zaleplon, or Sonata, may be useful for the short-term treatment of insomnia. While it may help a person fall asleep, it does not help maintain sleep.
A person taking Sonata has some risk of dependency. It also has a high likelihood of misuse.
A typical adult dose is
Sonata can cause a variety of side effects, including:
- difficulty concentrating
Less common side effects include hallucinations, mood changes, and memory loss.
Zolpidem, which has the brand names Ambien, Intermezzo, and Zolpimist, is a sleep medication that may help with falling asleep and sleep maintenance.
Doctors may prescribe it for short-term insomnia relief. Like some other sleep medications, it may cause complex sleep behaviors.
A doctor should prescribe the lowest effective dose, not exceeding 12.5 mg daily.
Doctors do not recommend a person take this medication during pregnancy. It can also lead to anaphylactic reactions, CNS depression, worsening depression, and withdrawal effects in some people.
Common side effects may include:
- next-day sleepiness
The table below compares the benefits and risks of these sleep medications.
|Medication brand name||Pros||Cons||Can it help a person fall asleep?||Can it help a person stay asleep?||Is there a risk of dependency and misuse?||Side effects|
|Silenor||may help a person fall and stay asleep||• may interact with other medications |
• may not be suitable for pregnant people
|yes||yes||unlikely||• CNS depression|
• changes in mood or behavior
• suicidal thoughts
|Restoril||strong sedative effect may help with insomnia||risk of dependency, withdrawal, and misuse||yes||yes||yes||• dry mouth|
|Lunesta||may help a person fall and stay asleep and is generally safe||can cause complex sleep behaviors, such as sleepwalking||yes||yes||yes||• dizziness|
• unpleasant taste
• viral infections
|Rozerem||not a controlled substance and has little chance of causing dependency||has the potential for adverse and allergic reactions in some people||yes||no||unlikely||• drowsiness|
• worsening insomnia
|Belsomra||may help a person fall and stay asleep||risk of dependency or misuse||yes||yes||yes||• diarrhea|
• dry mouth
• upper respiratory tract infection
|Halcion||may help a person fall asleep||only for short-term use||yes||no||yes||• lack of coordination|
|Desyrel||low dose antidepressant that may cause fewer side effects than traditional sleep medications||can cause mental health side effects, such as suicidal ideation||yes||yes||unlikely||• edema|
• blurred vision
• weight loss
• suicidal thoughts
|Prosom||may help a person fall and stay asleep||risk of dependency or misuse||yes||yes||yes||• lack of coordination|
• reduced movements
|Sonata||may help a person fall asleep||• risk of dependency and adverse effects|
• does not help maintain sleep
|yes||no||yes||• abdominal pain|
|Ambien, Intermezzo, Zolpimist||may help a person fall and stay asleep||may cause complex sleep behaviors and other adverse reactions||yes||yes||yes||• dizziness|
• next-day sleepiness
Though medications may help some people with insomnia, other remedies may also help a person fall asleep. Alternative treatments and lifestyle changes a person may find helpful include:
- herbal remedies, including supplements or teas
- relaxation techniques
- engaging in healthy sleep habits such as sleeping in a cool, dark room and avoiding distractions and large meals before bed
- increased exercise
- cognitive behavioral therapy
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 also pose a risk of dependency and misuse.
A person should talk with a doctor before and while using any sleep aid, making them aware of other substances they use and any side effects they experience.