Lack of sleep can have serious consequences—a higher risk of type 2 diabetes , obesity, heart disease, and other health conditions . It can also raise the risk of falling, particularly among older women, and increase the likelihood of having a car accident if you drive. Insomnia might also leave you feeling anxious, depressed, or irritable. Paying attention, learning, or remembering can become difficult.
Yet, in an effort to combat the condition, there is concern that sleeping pills are overprescribed. Drugs like Lunesta and Ambien have been heavily advertised both to doctors and consumers, which may have led to
excessive and overly casual use.
At the same time, studies have found that chronic insomnia is undertreated, and that fewer than half of the people who need help actually get it.
Four prescription drugs used to treat insomnia—eszopiclone (Lunesta and generic), ramelteon (Rozerem and generic), zaleplon (Sonata and generic) and zolpidem (Ambien, Ambien CR, Edluar, Zolpimist, and generic)—are effective but not necessarily better than behavioral therapy or older, less expensive drugs for many people who need a sleep aid.
Older prescription sedatives called benzodiazepines, such as estazolam (generic only), triazolam (Halcion and generic), and temazepam (Restoril and generic), might work just as well as the newer sleeping pills. Nonprescription drugs containing an antihistamine—for example, diphenhydramine (the active ingredient in Benadryl, but also sold as a sleep aid under the brand names Nytol and Sominex and as a generic) or doxylamine (Unisom and generic)—might help if you have suffered insomnia for just a night or two. Antidepressants, particularly trazodone, are also commonly prescribed for insomnia.
All insomnia medicines can cause side effects like daytime sleepiness, dizziness, unsteadiness, and could actually worsen your insomnia. Sleep-walking, sleep-driving, sleep-eating, memory lapses, and hallucinations have also been reported . The risk of developing a dependency on the drugs is also a problem. People who are age 55 or older should be cautious about taking sleeping pills because they are at higher risk of all the side effects from these medicines.
Sleeping pills should generally not be used long-term for chronic insomnia. If you have just one or two nights where you can't fall or stay asleep, it's better to try something else besides medication.
That said, people with persistent, chronic insomnia—three or more nights a week for months—should seek treatment. First to rule out whether your insomnia is due to other sleep disorders, medical conditions you have, or medications you take.
Studies have found that improving your sleep habits and making other changes like doing relaxation training, setting and sticking to consistent bedtimes and wake-up times, regular exercise , quitting smoking, cutting back on caffeine and alcohol, keeping your bedroom quiet and dark, and not watching TV or using computers in bed can relieve insomnia. If those don’t seem to help and you and your doctor decide a prescription sedative is an option to try, our analysis of the newer drugs led us to recommend generic zolpidem as a Best Buy. This is the less expensive, generic version of the drug Ambien. Seven pills cost $16 to $17, depending on the dose and where you buy it.