Sleep Disorders

Sleep medications:

Non-benzodiazepine Hypnotics

Often used for surgical anesthesia, non-benzodiazepine hypnotics are used to cause an individual to sleep, and are often used for the medical management of severe insomnia. Many (but not all) hypnotic drugs are addictive, and are often not the physician’s first resource for the treatment of insomnia.

Eszopiclone is more frequently known as Lunesta® (manufactured by Sepracor). It is less effective than some other insomnia treatments, but has several unique advantages. Eszopiclone has a much smaller chance of becoming addictive than other sleep aids, and is less likely to be used recreationally. It also works well for long-term use. The most frequent side effects reported are loss of coordination and dizziness.

Ramelteon is one of a newer series of drugs that selectively binds to melatonin receptors, and is currently the only prescription insomnia drug that is not scheduled under the United States Controlled Substances Act. It is approved for the long-term treatment of insomnia, particularly targeted to cases of delayed sleep onset. The main noted side effect of ramelteon is dizziness. Ramelteon is marketed as Rozerem® in the U.S. by Takeda Pharmaceuticals.

Zaleplon is mainly used to treat insomnia, and is manufactured by King Pharmaceuticals under the brand name Sonata®. Although zaleplon is not a benzodiazepine, it produces many of the same side effects: anterograde amnesia (inability to remember, especially during the period of the drug’s use), confusion, daytime drowsiness, agitation, and hallucinations. Zaleplon is a habit-forming drug.

Zolpidem is manufactured under several trade names; the most familiar being Sanofi-Aventis’ Ambien®. It is indicated for short-term insomnia treatment. Prescription Ambien is used as a “no-go” pill by the U.S. Air Force to facilitate sleep for pilots after a mission. Zolpidem is also used off-label to manage restless legs syndrome. If taken for an extended period, zolpidem has the potential to become addictive. It produces many side effects, among them: hallucinations and/or delusions, anterograde amnesia, decreased motor coordination, and impaired judgement.

Zopiclone is a short-acting hypnotic drug first developed by Sepracor, and currently produced by Sanofi-Aventis. In the United States, it is sold under the analogue of eszopiclone (see above), and sold under multiple other brand names worldwide. The most commonly reported side effects are a bitter metallic taste, dry mouth, and headache.

Tips for talking to your doctor about sleep problems