Sleeping Pills: Summary of Recommendations
Four drugs used to treat insomnia—eszopiclone (Lunesta), ramelteon (Rozerem), 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 for a night or two.
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)—and older prescription sedatives called benzodiazepines, such as estazolam (generic only), flurazepam (Dalmane and generic), and temazepam (Restoril and generic), might work just as well as the newer sleeping pills.
But we recommend that both prescription and nonprescription sleeping pills be used judiciously because research has found that people with mild insomnia sometimes unnecessarily take these medications when they might be able to resolve their sleep issues with nondrug measures.
In addition, all insomnia medicines can cause side effects and dependency, and even worsen your sleeping problems when abused, misused, or taken too often. Possible side effects include daytime sleepiness, dizziness, unsteadiness, and rebound insomnia. Sleep-walking, sleep-driving, sleep-eating, memory lapses, and hallucinations have also been reported.
That said, people with persistent, chronic insomnia—three or more nights a week for months—should seek treatment. We advise cognitive behavioral therapy—a form of psychotherapy—that can improve sleep habits, possibly combined with a cautious use of sleeping pills. Research has found this can help relieve chronic insomnia.
For the average person seeking short-term help—for a few nights—we suggest trying an over-the-counter sleep aid first. If that doesn't work, our comparison of the newer drugs led us to choose zolpidem as a Best Buy. This is the less expensive, generic version of the drug Ambien. Fifteen pills cost $27 to $31, depending on the dose and where you buy it.
This report was published in January 2012.