Mental health

Medicines for Insomnia

Persistent difficulty falling or staying asleep that affects daytime function — treated first with sleep habits and a structured talking therapy, with sleeping tablets reserved as a short-term last resort.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Insomnia?

Insomnia means regularly finding it hard to get to sleep, staying asleep, or waking too early and not being able to drop off again, despite having the chance to sleep — and feeling the effects during the day as tiredness, low mood, poor concentration or irritability. It is very common and can be short-lived, often after stress or a change in routine, or longer-lasting.

  • How it is treated: The first and most effective treatment is not a medicine at all.
  • Self-care: A regular sleep and wake time, a cool dark bedroom, avoiding caffeine and alcohol later in the day, getting daylight and activity during the day, winding down without screens before bed, and getting up rather than lying awake all help re-establish natural sleep.
  • When to seek help: See your GP if poor sleep persists for weeks, affects your daytime life, or comes with loud snoring and daytime sleepiness (which can signal sleep apnoea).

What it is

Insomnia means regularly finding it hard to get to sleep, staying asleep, or waking too early and not being able to drop off again, despite having the chance to sleep — and feeling the effects during the day as tiredness, low mood, poor concentration or irritability. It is very common and can be short-lived, often after stress or a change in routine, or longer-lasting. Insomnia is frequently a symptom of something else: anxiety, depression, pain, an overactive thyroid, alcohol or caffeine, certain medicines, or a sleep disorder such as sleep apnoea (where breathing repeatedly stops during sleep, often with loud snoring). Because of this, good treatment looks for and addresses the underlying cause rather than simply reaching for a tablet.

How it is treated

The first and most effective treatment is not a medicine at all. It is improving sleep habits (sleep hygiene) and, for longer-lasting insomnia, cognitive behavioural therapy for insomnia (CBT-I) — a structured talking therapy that retrains unhelpful sleep patterns and the anxious thinking that keeps people awake. CBT-I is recommended as the first-line treatment because it works as well as sleeping tablets and keeps working after it stops, without the risks of medication. Any underlying cause — anxiety, depression, pain, sleep apnoea, caffeine or alcohol — is treated in its own right. Sleeping tablets are very much a last resort: they are considered only for severe, disabling insomnia, used for the shortest possible time, because they cause dependence and tolerance, daytime drowsiness and falls, especially in older people.

For this condition, these medicines

Medicine classes used for Insomnia

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Melatonin Neurology A more natural sleep-signal hormone, used short-term in selected people — for example, older adults — when a sleep aid is needed. Benzodiazepines and Z-drugs Mental health Sleeping tablets used short-term only and as a last resort, because of dependence, tolerance, next-day effects and falls.

Symptom checker

Symptoms that can point to Insomnia

Insomnia can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

FatigueA persistent lack of energy or overwhelming tiredness that is not relieved by rest and int…Memory problemsMemory problems mean finding it harder to remember things or think clearly, which can have…Excessive daytime sleepinessA persistent struggle to stay awake during the day — nodding off, fighting heavy eyelids o…Difficulty concentrating / brain fogA frustrating sense of being mentally cloudy, forgetful or unable to focus, most often cau…

By active ingredient

Specific medicines used for Insomnia

Dose-free guides to individual active ingredients used in insomnia — what each is, how it works, how to take it, and its advantages and disadvantages:

DiphenhydramineAn older, sedating antihistamine that causes drowsiness — used in the UK mainly as a sleep…PromethazineA sedating older antihistamine used for allergies, short-term sleep problems, and nausea o…ZopicloneA Z-drug sleeping tablet used for short-term treatment of insomnia; it can cause next-day …TemazepamA benzodiazepine used for the short-term treatment of insomnia, helping people who are hav…ZolpidemA 'Z-drug' used for the short-term treatment of insomnia, helping people fall asleep when …NitrazepamA long-acting benzodiazepine sleeping tablet for short-term, severe insomnia; it can cause…LormetazepamA benzodiazepine sleeping tablet for the short-term treatment of insomnia.…ZaleplonA very short-acting Z-drug sleeping tablet for short-term insomnia.…DoxylamineA sedating antihistamine used as a short-term sleep aid and, combined with pyridoxine, to …EszopicloneA 'Z-drug' sleeping tablet used for short-term help with insomnia.…RamelteonA non-controlled sleep medicine that works on the body's melatonin system to help with tro…TriazolamA short-acting benzodiazepine used for the short-term treatment of severe insomnia.…EstazolamA benzodiazepine sleeping tablet used for the short-term treatment of insomnia.…SuvorexantA sleep medicine for insomnia that works by blocking orexin, a chemical that keeps the bra…TasimelteonA specialist sleep medicine used for non-24-hour sleep-wake disorder, mainly in people who…MelatoninA version of the body’s natural sleep hormone — used mainly for short-term insomnia in old…

Beyond medication

Lifestyle and self-care

A regular sleep and wake time, a cool dark bedroom, avoiding caffeine and alcohol later in the day, getting daylight and activity during the day, winding down without screens before bed, and getting up rather than lying awake all help re-establish natural sleep.

When to get help

When to see a doctor

See your GP if poor sleep persists for weeks, affects your daytime life, or comes with loud snoring and daytime sleepiness (which can signal sleep apnoea). If sleeplessness goes with low mood and thoughts of harming yourself, seek help now — contact your GP urgently, call 111, or call the Samaritans on 116 123.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Insomnia: frequently asked questions

What medicines are used for insomnia?

Sleeping tablets are a last resort, not a first step. When something is used short-term, options include melatonin (a more natural sleep-signal hormone, often in older adults) and the sleeping tablets known as benzodiazepines and Z-drugs. These are used for the shortest possible time because of dependence, tolerance and next-day effects. The mainstays of treatment are good sleep habits and cognitive behavioural therapy for insomnia (CBT-I).

Why won't my doctor give me sleeping tablets?

Sleeping tablets help in the very short term but stop working as the body gets used to them, can become hard to stop, and increase daytime drowsiness and the risk of falls. Because of this they are reserved for severe, short-term use. A talking therapy called CBT-I works as well and keeps working afterwards, so it is recommended first.

What is CBT-I?

Cognitive behavioural therapy for insomnia is a structured talking therapy that retrains the habits and anxious thoughts that keep people awake — such as spending too long in bed not sleeping, or worrying about not sleeping. It is the recommended first-line treatment for long-lasting insomnia and is available through self-help programmes, apps and therapists.

Could my insomnia be caused by something else?

Often, yes. Anxiety, depression, pain, an overactive thyroid, caffeine or alcohol, some medicines, and sleep apnoea can all disturb sleep. Treating the underlying cause usually does more for sleep than a sleeping tablet, which is why your clinician will ask about these.

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Sources

Where this is drawn from

  • NICE CKS: Insomnia.
  • NICE CKS: Insomnia.

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