Not all sleep medications work for everyone. Here’s how to work with your doctor to find the right treatment for you…
Go behavioral first. Consult a sleep physician or psychiatrist who practices cognitive behavioral therapy (CBT) for insomnia. Resource: BehavioralSleep.org (choose “United States” under “Providers”). These techniques might eliminate the need for medications and can be a crucial part of making sure that medications you do take are successful.
Over-the-counter (OTC) meds. Research the active ingredients and what they do. Examples: Pure Zzzs contains the sleep hormone melatonin, which modifies the sleep/wake cycle. ZzzQuil products contain diphenhydramine, the sleep-inducing ingredient in the antihistamine Benadryl. Rescue Sleep contains herbs such as impatiens and cherry plum that fight insomnia.
Prescriptions. Your doctor will try to determine the cause and nature of your insomnia before selecting a drug. If you have trouble falling asleep, you might need a short-acting drug. If you can fall asleep but awaken frequently due to stress, you might need a long-lasting drug that also combats anxiety. Responses to sleep medications vary, so don’t be surprised if trial and error is needed to find the right medication for you.
Here are the three main classes of drugs prescribed for insomnia…
Benzodiazepines (Klonopin, Xanax). Benzodiazepines are wide-spectrum medications that can act as hypnotics and muscle relaxants and have antianxiety and, in some cases, anti-epileptic effects. They become less effective over time and can cause side effects such as lethargy.
Z Drugs (Ambien, Lunesta, Sonata). These “next generation” meds activate certain brain receptors and leverage the sleepiness effect of benzodiazepines but without their other effects.
Dual orexin receptor antagonists—DORAs (Belsomra, Dayvigo, Quviviq). The newest generation of sleep meds are long-lasting and work in the opposite way of Z drugs, by blocking brain receptors that allow you to be awake.
Doctors also may prescribe antidepressants and antiseizure and antipsychotic medications off-label for insomnia.
