A Comparison of Prescription Insomnia Drugs

Sleep trouble is a common affliction in America. Over 40% of Americans will experience insomnia at some point in their lives. For millions, insomnia is a daily condition. It arises for a variety of reasons, ranging from short-term stress to chronic pain, to abnormal body rhythms. One option for treating insomnia is prescription sleep aids. This article rates and compares the four major sleep aids available on the market today.

This article is not intended to diagnose or treat any medical condition. It is merely meant to compare the advantages and disadvantages of each drug. The information contained was gained by the author's personal use and research of each drug. This article should not replace or supersede the advice of a medical professional. Take all drugs as they are prescribed, and do not take pills that are not prescribed to you.

There are some clinical terms you'll need to understand before discussing sleep aids. Half-life is the amount of time that your body takes to eliminate half of the drug from your system. Sleep aids have shorter half-lives than most drugs. This is how the drug is able to act only on during sleeping hours. Some sleep aids have a very short half-life (Sonata), while others span a full night of sleep (Lunesta).

Another term to understand is the non-benzodiazepine class of drugs. Abien, Lunesta, and Sonata all fall into this drug class. These are sedatives, and are chemically-distant relatives of more powerful anti-anxiety drugs like Valium and Xanax. Like their powerful cousins, non-benzodiazepines can be addictive if used daily for long periods or in high doses. One of the side effects of non-benzodiazepine drugs is a non-harmful type of memory loss. Generally, users will have little or no memory retention during the time the drug was having an effect. With sleep aids, this is not usually a problem since the user goes to bed immediately after taking a pill. However, people who take the drug may do things they don't remember, such as binge eating or talking on the phone. Sometimes this can lead to dangerous situations like driving or cooking, so sleep aid users should take precautions to avoid such situations.

There are some health insurance issues surrounding sleep aids. Insurers dislike paying for brand-name drugs, particularly "voluntary" pills like sleep aids. Many insurers limit the number of pills they will pay for each year. Some cut-rate insurers won't cover them at all. If an insurer refuses payment, the primary care provider may be able to override this refusal by certifying the patient requires the drug frequently.

Rozerem
Rozerem (or Ramelteon) is the only non-sedative sleep aid available on the market. Introduced in early 2006, it has zero ability to cause addiction. This makes Rozerem an attractive option for people who have prior substance abuse. Rozerem should be tried by individuals who do not respond to other sleep aids.

Rozerem works by interacting with melatonin receptors in the brain. Melatonin is the naturally occurring brain chemical that regulates sleep. The drug stimulates these receptors to cause the brain to enter sleep mode. Because of its mechanism of action, Rozerem has been nicknamed "super-melatonin." Rozerem can cause vivid dreams and nightmares. It also can be hard on the liver, so people with liver disease should use the drug with caution.

Lunesta
Lunesta is the brand name of eszopiclone, a non-benzodiazepine sleep aid. It has a long half-life of 6.5 hours. Except for the longer half-life, the chemical properties of Lunesta are very close to Ambien. It is a non-benzodiazepine sedative, although it has been shown to have very low addiction potential. Lunesta is a good choice for people who have problems with waking up too early. The long half-life ensures that the drug remains in high concentrations throughout the night. Users must have 8 hours before becoming active. Lunesta has all of the side effects found in non-benzodiazepine sedatives. Memory loss, sleepwalking, and abnormal behavior have higher occurrence rates with Lunesta. Users may have memory problems in the morning before the medicine wears off. Because it is fairly new, Lunesta is only available at brand name prices ranging from $4-$6 per dose.

Sonata
Sonata, or zaleplon, was released several years after Ambien due to a protracted patent dispute. It is the weakest of the sedative pills, but has its uses. The half-life of Sonata is only one hour, the shortest of all the non-benzodiazepine sleep aids. The short half-life makes Sonata handy for people who tend to awaken during the night, since it is OK to take another pill if the user has at least four hours before becoming active for the day. Sonata is also handy for air travelers, since it will be completely eliminated before most red-eye or intercontinental flights are complete. This prevents a side-effect called "travelers amnesia," where the user is still under the influence of the drug after a plane lands. Sonata tends to be cheaper than other non-benzodiazepine drugs due to its low market share.

Ambien
Ambien, or zolpidem, was the first non-benzodiazepine sleep aid. It holds a commanding market share of the sleep aid market-about 85%. It is often the first-line choice of physicians prescribing sleep aid drugs. Over the past 15 years, it has been shown to be effective and relatively safe. With a half-life of about two and half hours, it is effective for people who have trouble falling asleep and saying asleep. Eight hours after taking it, the drug is almost entirely eliminated from the system.

Ambien is now available as a generic. This means cheaper prices and better insurance coverage of the drug. Sanofi-Aventis, the inventor of brand name Ambien, has released a reformulation of the drug called Ambien CR. This formulation has time-release qualities, although it has been shown to only marginally increase the amount of sleep users get.
Generic zolpidem is the best all-around sleep aid on the market today. The drug is effective for the most common insomnia problems, although other drugs may be more appropriate for special-needs patients. With the generic availability of the drug, insurers are more likely to cover it.