Insomnia treatments
Sleeping pills are classified as pharmacist-only or prescription-only medicines. Some are restricted in their availability because of the risk of overdose or dependence and the need for counselling before they are prescribed.
While sleeping pills can help with insomnia, they are generally only recommended for short-term use.
Benzodiazepines and non-benzodiazepines
The so-called hypnotic class of medicines used to treat insomnia includes benzodiazepines and non-benzodiazepines. Doctors recommend that this type of medicine is used for short periods only — preferably intermittently (i.e. not every day) and for less than 2 weeks.
Examples of benzodiazepines include temazepam (e.g. Temaze, Normison), nitrazepam (e.g. Mogadon, Alodorm) and triazolam (Halcion). The non-benzodiazepines include zopiclone (Imovane, Imrest) and zolpidem (e.g. Stilnox, Dormizol). Zolpidem and zopiclone tend to cause less sedation in the mornings compared with benzodiazepines.
Some hypnotic medicines may be associated with potentially dangerous complex sleep-related behaviours, such as sleep walking, sleep driving and other bizarre behaviours.
Melatonin
Melatonin is a naturally occurring, sleep-promoting hormone. Medicine containing melatonin (Circadin tablets) can be prescribed for people aged 55 years or older for the treatment of insomnia. Melatonin can help you get to sleep, improve sleep quality and improve morning alertness. It should not be used continuously for more than 13 weeks.
Sedating antihistamines
Sedating antihistamines available through your pharmacist include diphenhydramine (Snuzaid, Unisom SleepGels), doxylamine (Dozile, Restavit) and promethazine (e.g. Phenergan).
While these medicines may be effective, they should not be used continuously for more than about 5 days, as tolerance to them may develop rapidly. They are sold in packs containing about one week’s supply.
Adverse effects of sedating antihistamines include daytime sedation, dry mouth, constipation and blurred vision. They should be used with caution in elderly people with cardiovascular disease.
Supplements
Herbal or plant-based supplements that may assist you to overcome sleeping difficulties include valerian, hops and passiflora.
Last Reviewed: 01 June 2011
- 1. Insomnia (revised October 2008). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2011 Mar. http://online.tg.org.au/complete/ (accessed May 2011).
2. Circadin Prescribing Information. RAD Data. Accessed via eMIMS. Date of TGA approved information: 4/01/2011.
3. BMJ Clinical Evidence. Patient Information from the BMJ Group. Insomnia (published Oct 2010). http://clinicalevidence.bmj.com/ (accessed May 2011).
