Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Insomnia definition and facts
- What is insomnia?
- 3 classes of insomnia based on the duration of symptoms and signs
- Signs and symptoms of insomnia
- Who gets insomnia?
- What causes insomnia?
- Insomnia caused by stress and lifestyle factors
- When should I call the doctor or other health care professional if I can't sleep?
- Is there a test to diagnose the condition?
- What are the treatments for insomnia; can it be cured?
- Natural and home remedies to cure insomnia
- Sleep hygiene
- Stimulus control
- Sleep restriction
- Benzodiazepine, non-benzodiazepine, and antidepressant medications to cure insomnia
- Melatonin, Rozerem, and Belsomra for problems sleeping
- Can insomnia be cured?
- Insomnia FAQs
- Find a local Sleep Specialist in your town
Benzodiazepine, non-benzodiazepine, and antidepressant medications to cure insomnia
The main classes of medications used to treat insomnia are the sedatives and hypnotics, such as the benzodiazepines and the non-benzodiazepine sedatives.
Several medications in the benzodiazepine class have been used successfully for the treatment of insomnia, and the most common ones include:
- quazepam (Doral),
- triazolam (Halcion),
- estazolam (ProSom),
- temazepam (Restoril),
- flurazepam (Dalmane), and
- lorazepam (Ativan).
Another common benzodiazepine, diazepam (Valium), is typically not used to treat insomnia due to its longer sedative effects.
Non-benzodiazepine sedatives are also used commonly for the treatment of insomnia and include most of the newer drugs. Some of the most common ones are:
- zaleplon (Sonata),
- zolpidem (Ambien or Ambien CR [note that as of January 1, 2014 the FDA changed the recommended dosage and precautions], Zolpimist, Intermezzo), and
- eszopiclone (Lunesta).
Some anti-depressants (for example, trazodone [Desyrel], amitriptyline [Elavil, Endep], doxepin [Sinequan, Adapin]) can be used effectively to treat insomnia in patients who also may suffer from depression. Some anti-psychotics have been used to treat insomnia, although their routine use for this purpose is generally not recommended.
Learn more about: Sinequan
Melatonin, Rozerem, and Belsomra for problems sleeping
Melatonin: a chemical released from the brain which induces sleep, has been tried in supplement form for treatment of insomnia as well. It has been generally ineffective in treating common types of insomnia, except in specific situations in patients with known low levels of melatonin. Melatonin may be purchased over-the-counter (OTC without a prescription).
Ramelteon (Rozerem): a newer drug that acts by mimicking the action of melatonin. It has been used effectively in certain groups of patients with the problem.
Learn more about: Rozerem
Antihistamines: There also other medications that are not in the sedative or hypnotic classes, which have been used in the treatment of insomnia. Sedative antihistamines, diphenhydramine (Benadryl) have been used as sleep aids because of their sedative effects. However, this is not a recommended use of these or other similar drugs due to many side effects and long-term drowsiness the following day.
Learn more about: Benadryl
A doctor or sleep specialist is the best person to discuss these different medications, and to decide which one may be the best for each specific individual. Many of these drugs have a potential for abuse and addiction and need to be used with caution. Several of these medications can not taken without the supervision of the prescribing doctor.
Can insomnia be cured?
Insomnia overall has a favorable outlook. Many cases of insomnia are related to transient situational stresses and are easily reversed when the situation is resolved. In cases of long-standing (chronic) insomnia, any medical or psychiatric cause needs to be assessed and treated. Medical and non-medical home remedies are available for treating insomnia and are generally successful. Combinations of non-medical and medical therapy are usually the most successful. Medical treatment for insomnia without addressing the underlying cause of a person's insomnia will often result in long-term medication use with no resolution of the underlying cause.
American Academy of Sleep Medicine. "Insomnia."
American Academy of Sleep Medicine. "Practice Guidelines."
Insomnia. In: American Academy of Sleep Medicine. The International Classification of Sleep Disorders. 2nd ed. Westchester, Illinois: American Academy of Sleep Medicine; 2005:1-31.
Past contributing medical author: Siamak T. Nabili, MD, MPH
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