Disclaimer: Human Health is not recommending any specific medical treatment for any particular symptom, nor providing any other medical advice. Always seek the advice of your doctor regarding any medical concern.

According to a 2022 CDC survey, over 36% of U.S. adults don’t get the recommended 7 hours of sleep each night. Sleep problems can be incredibly frustrating, and if they’re ongoing, may develop into a condition called insomnia. Insomnia is characterized by persistent difficulties with falling asleep, staying asleep, or getting good quality sleep. You can read more about insomnia here.

There are different types of treatments that people might take to help relieve the symptoms of insomnia.

Prescription medications

The FDA has approved a number of different medications that can be prescribed by a healthcare professional to treat insomnia.

Benzodiazepines and Z-drugs

Benzodiazepenes are a class of medications that enhance the effects of a chemical called GABA in the brain. GABA is an inhibitory chemical, which means that activation of GABA pathways decreases excitability of the cells in the brain, causing a decrease in brain activity. This can leading to feelings of relaxation and drowsiness.

Some examples of benzodiazepines approved to treat insomnia include estazolam (Prosom), quazepam (Doral) and temazopam (Restoril).

‘Z-drugs’ are a class of medications that work similarly to benzodiazepines. This category includes drugs like zaleplon (Sonata), zolpidem (Ambien), and eszopiclone (Lunesta).

Ramelteon

Ramelteon (Rozerem) is a medication that mimics the effects of a chemical in the brain called melatonin. A couple of hours before you go to bed, usually once it’s dark, your brain starts to produce melatonin to indicate that it’s time to start getting ready to sleep. Ramelteon acts like melatonin, but it’s more powerful than the natural form of the chemical, and so it works by making you feel sleepy.

Doxepin

Doxepin (Silenor) is an anti-depressant medication that is approved for the treatment of insomnia. It works by inhibiting the effects of a chemical called histamine in the brain. Histamine is important for making you feel alert, so by blocking the effects of histamine, doxepin can make you feel drowsy.

Orexin receptor antagonists

Orexin is another chemical in the brain that keeps you alert. Orexin receptor antagonists are a class of medications that block the effects of orexin in the brain, and by doing so, cause you to feel drowsy.

Some examples of orexin receptor antagonists include suvorexant (Belsomra), lemborexant (Dayvigo), and daridorexant (Quviviq).

Over-the-counter medications

There are some medications that are available without a prescription that people may use to help them sleep. Some of them are created to help treat insomnia, and others are designed to treat other symptoms and conditions, but may be used to treat insomnia as well since they cause drowsiness.

It should be noted that some of the products that include these ingredients may not be regulated by governing medical bodies, and you should consult with your healthcare practitioner before taking them.

There are a couple of ingredients in medicines that commonly fall within this category.

Melatonin

As mentioned above, melatonin is an important chemical in the brain that induces feelings of sleepiness before bedtime. Depending on where you live, melatonin may require a prescription, but in some places it is available without one. Taking melatonin before bed might enhance or trigger feelings of drowsiness.

Diphenhydramine

This is an ingredient is often found in allergy medications. It primarily works by blocking the action of a chemical in the body called histamine. Histamine is released by the immune system in response to foreign substances, leading to the classic allergy symptoms such as itching, redness, rash, and cough.

In the brain, histamine plays a role in maintaining wakefulness. By inhibiting the activity of histamine in the brain, diphenhydramine can trigger feelings of drowsiness.

Allergy medicines that have diphenhydramine in them are often marketed for night-time use as a result of its secondary effects on wakefulness. There are a number of preparations that contain diphenhydramine marketed specifically for sleep.

Doxylamine

This is an ingredient commonly found in medications used to ease nausea and vomiting, particularly for pregnant people. Doxylamine is also found in allergy medications, and in many medications marketed to induce sleep.

It’s also a histamine blocker, and works very similarly to diphenhydramine to cause drowsiness and reduce allergy symptoms. It may block histamine from acting on a part of the brain called the vomiting center, which is why it might work to reduce nausea and vomiting in pregnant people.

Supplements

There are other dietary supplements that many people believe to be helpful for treating insomnia.

Valerian root

Extracts from valerian root are commonly included in supplements marketed for improving sleep. There are a couple of theories about how it might work for sleep, including that valerian promotes the release of a chemical called GABA, which can decrease the excitability of cells in the brain and nervous system, leading to a more relaxed, drowsy state.

The available evidence for how and if it works is limited, and studies which surveyed people using valerian root to treat sleep problems have reported mixed results. Clinical guidelines do not recommend using valerian for chronic insomnia in adults.

Magnesium

Magnesium is a mineral the body needs to function properly, and it has now become a popular supplement for people trying to ease insomnia. Again, the evidence regarding the effects of magnesium on sleep is limited.

Magnesium may also activate GABA to reduce excitability of the nervous system, it may promote muscle relaxation, and may decrease the levels of a stress hormone, called cortisol, in the body. However, the exact mechanism by which magnesium may improve sleep has not been elucidated.

Chamomile

Often available in teas, chamomile is age-old natural remedy that has been used to promote relaxation and sleep for thousands of years. An animal study found that chamomile reduced motor activity in mice, which may indicate that the herbal remedy induces sedation.

It is possible that certain compounds found in chamomile may act like benzodiazepines to induce feelings of drowsiness, but further research is necessary to confirm if and how chamomile improves sleep.

Lifestyle changes

Sleep hygiene

Sleep hygiene refers to creating routines, habits, and an environment that allows you the best chance at getting a good night’s sleep. Some examples of things you can do to improve your sleep hygiene include:

• Keeping work and study outside the bedroom
• Adjusting the lighting so that the bedroom stays dark
• Using fans, blankets, or heaters to keep the room at a comfortable temperature
• Keeping the room tidy
• Avoiding screen use before bed

To learn more about sleep hygiene, you can read our blog post on sleep tips here.

Exercise

Although it’s unclear exactly how exercise affects sleep, research has shown that exercising may improve sleep quality. It is suggested that moderate-intensity exercise positively impacts mood and reduces stress, which could have flow-on effects for quality of sleep. Physical activity also uses up energy, and so you may feel more tired at the end of the day as a result, which could help you fall asleep.

The Physical Activity Guidelines for Americans, published by the U.S. Department of Health and Human Services, note that exercise can make you fall asleep faster, stay asleep longer, and reduce feelings of sleepiness during the daytime.

Avoid stimulants

Stimulants include substances such as caffeine and nicotine, as well as certain medications that are designed to increase alertness and attention such as methylphenidate (Ritalin, Concerta),  amphetamine and dextroamphetamine (Adderall) and lisdexafetamine (Vyvanse). Many other medications can have stimulant effects, although that is not their main purpose.

Stimulant use close to bedtime may impact your ability to fall asleep, since they can make you feel more awake and alert. Some people even report that drinking coffee or tea past lunch-time can make it harder for them to fall asleep.

We hope this post has helped you learn more about common treatments for insomnia. If you know someone who could benefit from reading this post, please share it with them. We’d love for our resources to reach those who need them.

Resources

1. U.S. Centers for Disease Control and Prevention (CDC). FastStats: Sleep in Adults. Available at: https://www.cdc.gov/sleep/data-research/facts-stats/adults-sleep-facts-and-stats.html
2. Harvard Medical School. Division of Sleep Medicine. Insomnia Medications. Available at: https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-84
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11. National Institutes of Health (NIH). Office of Dietary Supplements. Dietary Supplement Fact Sheets for Health Professionals: Valerian. Available at: https://ods.od.nih.gov/factsheets/Valerian-HealthProfessional
12. Valéria Valente, Daniela Machado, Susana Jorge, Christopher L. Drake, Daniel Ruivo Marques.Does valerian work for insomnia? An umbrella review of the evidence. European Neuropsychopharmacology. Volume 82, 2024, 6–28. Available at: https://www.sciencedirect.com/science/article/pii/S0924977X24000294
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15. Victorian State Government Department of Health. Better Health Channel. Sleep Hygiene. Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sleep-hygiene
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17. Healthdirect Australia. Exercise and mental health. Available at: https://www.healthdirect.gov.au/exercise-and-mental-health
18. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018. Available at: https://odphp.health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
19. National Health Service (NHS). Attention deficit hyperactivity disorder (ADHD) Treatment.

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