Prescription Sleep Medications: Weighing Your Options and Choosing a Drug

A few decades ago your only prescription options for a good night's sleep were benzodiazepine hypnotics like Xanax or Halcion. These pills are still widely prescribed, but patients today have more choices: Similar medications called nonbenzodiazepines and an even newer drug that stands alone in its own class.

When you just need some shut-eye, though, having multiple options can make things even more complicated and confusing. Here are some quick descriptions to help you sort through the main differences and similarities.

Benzodiazepines

• Include older drugs such as Valium, Klonopin, Xanax, and Halcion
• Induce sleep by slowing down the central nervous system
• Are often used to treat anxiety and panic disorders as well as insomnia
• Are approved for short-term use (a few weeks or less) by adults, though many doctors prescribe them for longer
• Cost less than the newer medications—in some cases, about 75 cents a pill—because they are available as generics.
• May make symptoms of sleep apnea and other breathing disorders worse
• Have a low risk of abuse or dependence (although slightly higher than other sleep medications)
• Can cause side effects such as: residual daytime sleepiness, cognitive impairment, memory loss, falling and motor impairment (especially among older people), and the return, or "rebound," of insomnia after abruptly discontinuing a drug
• In a 2006 government-sponsored analysis, benzodiazepines caused patients to fall asleep 10 minutes faster and sleep 32 minutes longer than those who took placebo pills.