A Quick Guide to Common Prescription Sleep Aids

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Tuesday, August 28, 2018

For the millions of Americans who struggle with sleep issues, prescription sleep aids may provide relief. Along with helping to treat insomnia, they can help people fall asleep faster, and sleep more soundly. There are many types that your doctor can prescribe: Each contains different ingredients and can vary in its effects. While you should always seek the advice of your doctor when deciding which sleep aid or lifestyle adjustment is the best course of action to improve your sleep, this quick guide highlights the differences between common prescription sleep aids and how they work to help you sleep better.


Orexin Receptor Antagonists

The most recent class of insomnia drugs approved by the FDA, orexin receptor antagonists work very differently than the sleep aids that came before them. While many traditional prescription sleep aids increase levels of the neurotransmitter GABA, this new class works by inhibiting the activity of the chemical orexin in the brain.  Orexin plays an important role in keeping people awake and alert, so blocking it may help promote sleep.  Importantly, this new class of sleep medication targets a localized area of the brain; as such, it may have fewer side effects than other drugs. Currently, Suvorexant is the only FDA-approved orexin receptor antagonist available.



Prescribed by physicians since the 1960s, benzodiazepines work by enhancing the action of GABA, a neurotransmitter that slows activity in the brain  helping people fall asleep more quickly and stay asleep longer. Although they have been found to be effective in the short-term, long-term use of benzodiazepines may not be advisable as they can have side effects, including a reduced duration of deep sleep and a gradual building of tolerance that may require people to increase dosage over time.  Flurazepam, Triazolam, Temazepam, Diazepam, Alprazolam, and Lorazepam are all commonly prescribed benzodiazepines.


Non-Benzodiazepine Hypnotics

Although structurally different than benzodiazepines, non-benzodiazepine hypnotics work in a similar way, by binding to benzodiazepine-like receptors in the brain that increase the levels of GABA. This in turn, slows activity in the brain, inducing sleepiness. Rather than affecting multiple brain receptors as benzodiazepines

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