From the Guidelines
Trazodone is not recommended for the treatment of sleep paralysis or chronic insomnia due to its adverse effect profile and lack of strong evidence supporting its efficacy. According to the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guidelines 1, trazodone was found to have no differences in sleep efficiency or rate of discontinuation due to adverse events compared to placebo in patients diagnosed with chronic insomnia. Although trazodone was more effective at improving subjective sleep quality, the low-quality evidence supporting its efficacy was outweighed by its adverse effect profile.
Some key points to consider:
- The American Academy of Sleep Medicine clinical practice guideline suggests that clinicians not use trazodone as a treatment for sleep onset or sleep maintenance insomnia in adults 1.
- Trazodone is often prescribed off-label for sleep disorders at lower doses, but its efficacy for this indication is not well established 1.
- Improving sleep hygiene, such as maintaining a regular sleep schedule, avoiding caffeine and alcohol before bed, and creating a comfortable sleep environment, may be beneficial for individuals experiencing sleep paralysis or insomnia.
- If sleep paralysis is frequent or distressing, consulting a healthcare provider can help determine the best course of treatment, which may include cognitive behavioral therapy for insomnia (CBT-I) or other evidence-based treatments.
It's essential to prioritize the patient's safety and well-being, and the potential risks and benefits of trazodone should be carefully weighed before initiating treatment. In general, non-pharmacological interventions, such as CBT-I, should be considered as the first-line treatment for insomnia and sleep paralysis 1.
From the Research
Trazodone and Sleep Paralysis
- There is no direct evidence in the provided studies that links trazodone to sleep paralysis.
- However, the studies do show that trazodone can improve sleep quality and duration in patients with insomnia 2, 3, 4, 5, 6.
- Trazodone has been shown to increase total sleep time, slow wave sleep, and reduce the number of awakenings and waking time after sleep onset 5.
- It is possible that improved sleep quality and duration may indirectly reduce the occurrence of sleep paralysis, but this is speculative and not supported by the provided evidence.
- The studies suggest that trazodone can be an effective treatment for insomnia, but its use should be cautious due to potential side effects such as daytime drowsiness and decreased appetite 5.