Understanding Your Options for Managing Insomnia: Not All Medicines Are Created Equal

This article is for people who have been diagnosed with and/or are living with insomnia, or people who have trouble sleeping at night, and their care partners, or anyone who wants to learn more about insomnia. The goal of this activity is to help you talk to and work with your doctor and healthcare team about medicines to help manage insomnia.

You will learn about:

• Insomnia, its symptoms, and complications (additional problems) that can happen

• Ways to help manage insomnia, including medicines and their possible side effects

• Talking to your doctor about making a treatment plan for insomnia that's right for you

• Questions you can ask your doctor and healthcare team

Insomnia is a common sleep disorder that can happen to most people at some point. It can happen to anyone at any age, but can become more common as you get older. Insomnia may also come and go.

With insomnia, you may have trouble falling asleep, have trouble staying asleep, and/or wake up too early and can't fall back asleep.

Insomnia can be acute (short-term) and last from 1 night to a few weeks. Many adults can experience acute insomnia, often because of an upsetting or stressful event. But when sleep problems happen at least 3 nights a week for 3 months or more, it's chronic (long-term) insomnia.

Getting enough sleep is important for your body and brain. Most adults need around 7 to 8 hours a night. Some can get less and it may not bother them, but losing out on sleep can affect both your physical and mental well-being.

In addition to problems with sleep, insomnia can affect how you function during the day and your daily life with symptoms such as:

• Not waking up well rested or refreshed

• Feeling tired, sleepy, or drained during the day

• Lower energy levels

• Feeling irritable, anxious, or depressed

• Worrying about sleep

• Feeling dissatisfied or unhappy with how good your sleep is (quality) or how much you get (quantity)

• Trouble paying attention, remembering, or concentrating

• Making mistakes more easily or having accidents

Insomnia can greatly affect your quality of life, including your daily activities, mood and behavior, relationships, and even your physical health.

Complications (additional problems) that can happen with insomnia can include:

• Problems with work or school

• Being slower to react, including while driving or operating equipment

• A higher risk of getting or having more severe depression, heart disease, high blood pressure, or obesity

Whatever the cause of your insomnia, losing out on sleep can affect your quality of life and your physical and mental well-being. So talking to your doctor about your sleep problems is the first step to getting care.

They can help find the cause of your insomnia, and together you can make a treatment plan to help manage insomnia and its symptoms. If you have acute insomnia, you may not need treatment, but sometimes insomnia can last for years.

Ways to help manage insomnia that your doctor may recommend, alone or in combination, can include:

• Developing good sleep habits or "sleep hygiene"

• Lifestyle changes

• Behavioral therapy

• Medicines

Depending on your symptoms and what kinds of sleep problems you're having, types of medicines your doctor may recommend can include:

• Benzodiazepine receptor agonists (BzRAs) that help you fall asleep (sleep onset) and/or stay asleep (sleep maintenance). These include benzodiazepines and non-benzodiazepine sedatives (sometimes called "z-drugs")

• Dual-orexin receptor antagonists (DORAs) that help with sleep onset and/or sleep maintenance

• Histamine receptor antagonists that help with sleep maintenance

• Melatonin receptor agonists that help with sleep onset

All medicines can have side effects. Some side effects that may happen with medicines for insomnia can include:

• Sleepiness, drowsiness, or fatigue (tiredness)

• Dizziness

• Taste changes, nausea, diarrhea

• Headache

• Infection

Some medicines may also cause morning sleepiness or be addictive, while others may affect your alertness and coordination.

Not all possible side effects are listed here -- be sure to ask your doctor, pharmacist, or healthcare team member for a complete list.

When it comes to insomnia, different treatments work differently, and what works for someone else may not be right for you.

If your doctor recommends medicine, the choice will depend on several factors including the type of insomnia and your symptoms, your age and overall health, other health conditions you have and medicines you take, and your lifestyle and schedule.

Be sure to take all medicines as directed by your doctor. Ask them about when to take it, for how long, and possible side effects. Certain medicines shouldn't be taken unless you're able to get a full 7 or 8 hours of sleep, and some should be taken within 30 minutes of going to bed.

In addition, some medicines may be taken long term, while others should only be taken for a short time.

Let your doctor know about your sleep problems, especially if they're interfering with your daily activities. Together, you can make a treatment plan to help manage insomnia and its symptoms and improve your quality of life.

Questions you can ask can include:

• What may be causing my sleep problems?

• Is there treatment that can help improve my symptoms and quality of life?

• When, how, and for how long should I take treatment, and what are the possible side effects?

• How can I expect to feel when I wake up or throughout the next day?

• What should I do if I feel stressed or depressed?

Congratulations!

You have successfully completed the program Understanding Your Options for Managing Insomnia: Not All Medicines Are Created Equal.

View Additional Materials on this topic that you may find useful:

Sleep and Sleep Disorders

Key Sleep Disorders

Do You Get Enough Sleep?

Tips for Better Sleep

PDF Downloads

Patient Handout