Medicines and Products for Insomnia

Medicines can help with insomnia in some situations, but they are usually used for a short time and alongside behaviour change. A doctor should prescribe and review them.

First choice: CBT-I

Cognitive behavioural therapy for insomnia is the recommended first treatment for chronic insomnia. It is not a medicine, but it has the best long-term results.

Prescription sleep medicines

• Z-drugs such as zolpidem and benzodiazepines such as clonazepam or lorazepam are used for short periods.
• Risks include next-day drowsiness, falls, memory problems, sleep-driving, dependence and withdrawal.
• Older adults have a higher risk of falls and confusion.
• They should not be combined with alcohol or other sedatives.
• Sedating antidepressants in low doses, or other medicines, may be used for certain people. Your doctor will weigh benefits and side effects.
• Orexin receptor antagonists and other newer medicines are available in some places.

Melatonin

• May help with jet lag, shift work and some delayed sleep timing.
• The right dose and timing matter. Ask your doctor, especially for children, in pregnancy and with other medicines.

Over-the-counter products

• Antihistamine sleep aids can cause next-day drowsiness, confusion and dry mouth, and are not advised for older adults or long-term use.
• Herbal products have limited evidence and can interact with medicines.

Safety

• Do not use sleeping pills for children or teenagers without a specialist.
• Do not take someone else's medicines.
• Do not drive after taking a sleeping pill until you know how it affects you.
• Do not stop long-term sleeping pills suddenly. Ask your doctor about a gradual plan.
• Pregnant or breastfeeding women need medical advice before any sleep medicine.

Key point

Medicines are a short-term aid. Treat the cause and use CBT-I for lasting change.

Before your appointment

Keep a sleep diary for 1 to 2 weeks, noting bedtime, wake time, night awakenings, naps, caffeine and alcohol. List all medicines, herbs and sleeping aids you take. Mention snoring, breathing pauses, leg discomfort, pain, low mood, anxiety and daytime sleepiness while driving. Ask about CBT-I, tests, medicine options and the warning signs that mean you should call 112 or Tele-MANAS at 14416.