From the Guidelines
Eszopiclone is the most recommended medication to help stay asleep, with a suggested dose of 2 mg or 3 mg, as it has been shown to be effective in treating sleep onset and sleep maintenance insomnia in adults. Several medications can help individuals stay asleep throughout the night, including orexin receptor agonists, BZD receptor agonists, and heterocyclics.
- Orexin receptor agonists, such as suvorexant, have been suggested as a treatment for sleep maintenance insomnia, with trials of 10, 15/20, and 20 mg doses showing effectiveness 1.
- BZD receptor agonists, including eszopiclone and zolpidem, have been recommended for sleep onset and sleep maintenance insomnia, with eszopiclone trials using 2 mg and 3 mg doses, and zolpidem trials using 10 mg doses 1.
- Heterocyclics, such as doxepin, have been suggested as a treatment for sleep maintenance insomnia, with trials of 3 mg and 6 mg doses showing effectiveness 1. However, other medications, such as trazodone, tiagabine, diphenhydramine, melatonin, L-tryptophan, and valerian, have been suggested not to be used as treatments for sleep onset or sleep maintenance insomnia due to lack of effectiveness or potential side effects 1.
- It is essential to consult a healthcare provider before taking any sleep medication, as they can help determine the best course of treatment and recommend the most suitable medication and dosage.
- Additionally, practicing good sleep hygiene, such as maintaining a consistent sleep schedule, avoiding screens and caffeine before bed, and creating a relaxing sleep environment, can also help improve sleep quality.
From the FDA Drug Label
The effect of eszopiclone on reducing sleep latency and improving sleep maintenance was established in studies with 2100 subjects (ages 18 to 86) with chronic and transient insomnia in six placebo-controlled trials of up to 6 months’ duration. Eszopiclone significantly decreased sleep latency and improved measures of sleep maintenance (objectively measured as wake time after sleep onset [WASO] and subjectively measured as total sleep time).
Eszopiclone is a medicine that can help stay asleep by improving sleep maintenance, which is measured by wake time after sleep onset (WASO) and total sleep time 2.
- Key benefits of eszopiclone include: + Decreased sleep latency + Improved sleep maintenance + Effective for chronic and transient insomnia The recommended adult dose is 2 to 3 mg and the elderly dose is 1 to 2 mg 2.
From the Research
Medicines to Stay Asleep
- There are several medicines that can help individuals stay asleep, including: + Ramelteon, a melatonin receptor agonist that has been shown to improve sleep latency and total sleep time 3 + Non-benzodiazepine hypnotics such as zolpidem, zolpidem-controlled release, zaleplon, zopiclone, and eszopiclone, which are generally well tolerated and have a favorable safety profile 4 + Melatonin, an endogenous hormone that can synchronize circadian rhythms and improve sleep quality, with minimal side effects 5
- The choice of hypnotic agent depends on the specific symptoms and needs of the individual, with options including: + Suvorexant or low-dose doxepin for sleep maintenance 6 + Eszopiclone or zolpidem extended release for both sleep onset and sleep maintenance 6 + Low-dose zolpidem sublingual tablets or zaleplon for middle-of-the-night awakenings 6
- It's worth noting that benzodiazepines should not be used routinely due to their potential for dependence and abuse 6
- Additionally, non-FDA-approved hypnotic agents such as melatonin, diphenhydramine, tryptophan, and valerian may be used, but their benefits and harms are not well established 6