Insomnia: Should I take sleeping pills?

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Take sleeping pills for a short time, along with making lifestyle changes.
Treat your sleep problems with only lifestyle changes.

Insomnia can be caused by menopause or problems such as depression, anxiety, and sleep apnea. Treating these conditions may get rid of your sleep problem. This topic is for people whose sleep problem can't be treated by fixing something else.

Key points to remember

Sleeping pills work best and are safest if you use them for a short time along with lifestyle changes.
Research shows that lifestyle and behavior changes are the best long-term choice to help you sleep well.
Sleeping pills may have side effects, such as daytime drowsiness and nausea.
A sleep medicine may not work as well when your body gets used to it.
You can become addicted to some types of sleeping pills if you take them for more than a few weeks.
You may have withdrawal symptoms when you stop taking the medicines.

FAQs

What is insomnia?

Insomnia is a problem with falling asleep or staying asleep. You may wake up during the night or wake up too early the next morning. Without enough sleep, you may feel sleepy during the day. This can make you more likely to have an accident, and it also makes driving dangerous. You may feel grumpy from lack of sleep. Some people have trouble remembering things, don't get as much done, and don't enjoy being with family and friends.

Some people use caffeine to help them get over feeling tired, but this may make their sleep problem worse.

Almost everyone has trouble sleeping sometimes. Stress, for example, can keep you from sleeping well now and then. The problem can last for days or weeks. It often gets better in less than a month.

But trouble sleeping can turn into a long-term problem, especially when you worry about not sleeping well. A long-term sleep problem is called chronic insomnia. It is often a symptom of another health problem, such as depression or chronic pain. Chronic insomnia is less common than short-term sleep problems.

How well do sleeping pills work?

Sleeping pills work well to help you sleep.¹ They can help for a short time to break the cycle of bad sleep. But over time, the medicine doesn't work as well as lifestyle and behavior changes do.²

Your doctor may have you take a sleeping pill every night for a few weeks. Or you may take them for only a few nights each week. This is called intermittent treatment. Make sure to take the pills exactly as your doctor says.

What lifestyle and behavior changes can you make to sleep better?

The best long-term way to sleep well is to make lifestyle and behavior changes.² There are several things you can try, including:

Changes in how you sleep. There are simple changes you can make that may help you sleep better. These include changing where or when you sleep, being careful about what and when you eat and drink, and being more active. It's also important to keep regular bedtimes and wake times—7 days a week—and to try to avoid taking naps during the day. For more information, see:
Insomnia: Improving your sleep.
Relaxation exercises. They can help slow your racing mind. For more information, see:
Stress management: Breathing exercises for relaxation.

Stress management: Doing guided imagery to relax.

Stress management: Doing meditation.

Stress management: Doing progressive muscle relaxation.

Stress management: Relaxing your mind and body.
Positive thinking with cognitive-behavioral therapy. Positive thinking, or healthy thinking, is a way to help you stay well or cope with a health problem by changing how you think. Cognitive-behavioral therapy is a type of counseling that can help you understand why you have sleep problems. And it can show you how to deal with them. Research shows that cognitive-behavioral therapy helps reduce interrupted sleep over time.³

What are the risks of taking sleeping pills?

Sleeping pills may:

Have side effects, such as making you feel anxious or sick to your stomach (nauseated). You also may feel sleepy or drowsy during the day.
Not work as well over time. After a while, they may not help you sleep the way they used to.
Become habit-forming. You may come to rely on them so much that you can't sleep without them.
Cause withdrawal symptoms when you stop taking them.

Why might your doctor recommend that you take sleeping pills?

Your doctor may recommend sleeping pills if:

You need help right away for a sleep problem that is causing problems in your life.
You have tried lifestyle changes and you still have trouble sleeping.
You plan to take them for only a few weeks.
You plan to try lifestyle changes along with taking sleeping pills.

2. Compare Options

	Take sleeping pills	Don't take sleeping pills
What is usually involved?	You take a sleeping pill every night or a few times a week as your doctor prescribes. You make lifestyle and behavior changes to help you sleep. These may include: Going to bed at the same time each night and getting up at the same time each morning. Not eating too much or drinking alcohol before bed. Not getting too much caffeine from drinks or foods.	You make lifestyle changes to help you sleep. These may include: Going to bed at the same time each night and getting up at the same time each morning. Not eating too much or drinking alcohol before bed. Not getting too much caffeine from drinks or foods.
What are the benefits?	You'll probably be able to sleep right away. You may be less tired and more able to concentrate during the day.	You help yourself get to sleep. You don't have to take a pill every day. You don't have the cost of medicine. You don't have to worry about depending on medicine to sleep. You don't have the risk of withdrawal symptoms or possible side effects. You can decide later to take sleeping pills if lifestyle changes don't work well enough.
What are the risks and side effects?	Sleeping pills may not work as well as they once did if you take them for a long time. You may come to depend on them for sleep and not be able to sleep without them. You could have withdrawal symptoms when you stop taking them. The pills can cost a lot. Sleeping pills have several possible side effects, including making you feel: Sleepy or drowsy during the day. Sick to your stomach. Anxious.	Lifestyle changes alone might not be enough to help you sleep.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

If you need more information, see the topic Insomnia.

Personal stories about taking sleeping pills for insomnia

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I used to have a stressful job and would wake up at night after a few hours of sleep. I couldn't go back to sleep. The same thing happened night after night. My blood pressure went up, and I was tired all the time. I have since changed to a less stressful job, but I still didn't sleep all night. I bought a better mattress hoping that would help, but I would still wake up in the middle of the night and not be able to get back to sleep. I talked with my doctor several times about my insomnia and decided to try sleeping pills. "

— Liz, age 45

"I kept many bad habits I had picked up in college. I would stay up late with friends, often while drinking. The next day at work I would drink coffee all day to help keep me going. I ate meals whenever I could spare the time. As a result I wasn't sleeping regularly. I thought about taking sleeping pills, but I didn't like the possible side effects. So I decided to make changes in my behavior. I go to bed at about the same time every night, exercise after work 3 days a week, and limit how much alcohol and coffee I drink. "

— Alejandro, age 25

"I used to worry about not going to sleep at night. So I would sit up late at night watching TV in bed. The more I worried about not being able to go to sleep, the longer I would stay awake. My doctor said I may be depressed and told me that counseling might help. He also suggested that I take sleeping pills for a short time to help me get the rest I need. "

— Chris, age 33

"I have several health problems and have started taking medicines for them. Since I started the medicines, I have a hard time going to sleep at night. My doctor believes that one of my medicines may be causing me to stay awake. So she recommended I try a different medicine to see if that would help. She also suggested that exercise might help, so I've started walking around the neighborhood after my evening meal. "

— Sophie, age 66

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take sleeping pills

Reasons not to take sleeping pills

I've tried lifestyle changes, and I'm still not sleeping enough.

I want to give lifestyle changes more time to work.

More important

Equally important

More important

I need to sleep better now, because lack of sleep is hurting my life.

My life isn't suffering because of my lack of sleep.

More important

Equally important

More important

I'm not concerned about getting addicted to the pills.

I'm very concerned about getting addicted to the pills.

More important

Equally important

More important

I'm not worried about side effects from sleeping pills.

I am worried about side effects.

More important

Equally important

More important

I don't mind taking medicine to help me sleep.

I just don't want to take pills to help me sleep.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking sleeping pills

NOT taking sleeping pills

Leaning toward

Undecided

Leaning toward

5. Quiz Yourself

Check the facts.

1. Is it best if you take sleeping pills only for a short time?

Yes
No
I'm not sure

That's right. Sleeping pills work best and are safest when taken for a short time. And it's a good idea to make lifestyle changes at the same time.

2. Will lifestyle and behavior changes work best over time to help you sleep?

Yes
No
I'm not sure

That's right. Lifestyle and behavior changes are the best long-term way to sleep well.

3. Is there a risk of getting addicted to sleeping pills?

Yes
No
I'm not sure

That's right. You can become addicted to some types of sleeping pills if you take them for more than a few weeks.

Decide what's next.

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty.

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

Nothing. I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

References

Citations

Estivill E, et al. (2003). Consensus on drug treatment, definition, and diagnosis for insomnia. Clinical Drug Investigations, 23(6): 351–385.
Smith MT, et al. (2002). Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. American Journal of Psychiatry, 159(1): 5–11.
Edinger JD, et al. (2001). Cognitive behavioral therapy for treatment of chronic primary insomnia: A randomized controlled trial. JAMA, 285(14): 1856–1864.