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Prescription drugs for insomnia
Prescription hypnotic drugs act in areas of the brain to help promote sleep. There have been advances with the development of more short-acting drugs to decrease drowsy spillover effects in the morning. Sonata (zaleplon), for example, is a drug designed to help you fall asleep faster, but not for keeping you asleep. Ambien (zolpidem) is an example of a drug indicated for both getting to sleep and staying asleep. These drugs, called non-benzodiazepines, have been joined by Lunesta, the first prescription sleep aid approved by the FDA for long-term use. It also carries a low risk of next-day grogginess.

Hypnotic/sedative drugs are potentially addictive. Generally, their use is limited to 10 days or less, and the longest that they are approved for use is about 30 days, says Paul Andreason, M.D., a drug reviewer in the FDA's Division of Neuropharmacological Drug Products.

Seroquel (quetiapine), an atypical antipsychotic, is sometimes prescribed as a sleep aid because it can be sedative.

Non-prescription sleep aids
Non-prescription, "over-the-counter" (OTC) sleep aids can help, but may be less effective than prescription drugs. They may have been subjected to less rigorous testing. Many of these, such as "PM" pain relievers, include antihistamines, which are designed to block chemicals released during a cold or allergy attack but can also have a sedating effect.

Several over-the-counter pain remedies, like Excedrin and Tylenol, come in a "PM" version free of caffeine but with an antihistamine that makes people sleepy.

As with hypnotics, OTC sleep aids should not be used by individuals who are also taking alcohol or other drugs with sedating effects. Older persons should be cautious about these drugs because of their slower metabolisms. Drugs stay in the body longer and can then cause daytime sleepiness. In addition, OTC sleep aids should be avoided by people with breathing problems, glaucoma, chronic bronchitis, and difficulty urinating because of an enlarged prostate gland, or women who are pregnant or nursing.

Natural Remedies

Natural insomnia remedies used by some to promote sleep include:

• Valerian (a root that may be steeped in hot water for tea)
• Hops (especially in combination with valerian.)
• Melatonin (an artificial or animal form of a substance produced by humans that is linked to sleep)
• Lavender water sprinkled or sprayed on bedding can make you sleepy, and so can scents of vanilla and green apple.
• Essential oils of Ylang ylang, chamomile, peppermint, eucalyptus, lemongrass and rose. To get the full effect, be sure to use true essential oils, which are 100% pure.

Herbal products and nutritional supplements are not required to undergo the same rigorous testing as drugs do in order to meet government standards. Their long-term impact, side effects and possible interactions with other drugs or medical conditions are often not known. Discuss their use with your doctor.

Light therapy
Recent research has found that sleep may be improved by using a pair of blue-blocking lenses to simulate darkness several hours before one wishes to fall asleep. This may allow the biological clock to re-organize itself and synchronize around a more regular schedule. You can read about this research in Bipolar disorder - Light and darkness by Jim Phelps, MD, Psycheducation.

Pt. 1: Why is sleep important? >>
Pt. 3: Tips for a good night's sleep >>

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Page updated June 1, 2009