Sleep Onset vs Maintenance Medications

Important Notice: Different sleep problems require different solutions. Sleep onset insomnia (trouble falling asleep) and sleep maintenance insomnia (trouble staying asleep) often need different medications.

Medication Type Primary Use Effectiveness Duration Timing Best For Considerations
Zolpidem (Ambien) Prescription Sleep Onset High Short At bedtime Trouble falling asleep Quick acting, short duration
Eszopiclone (Lunesta) Prescription Both High Long At bedtime Both onset and maintenance Longer acting
Suvorexant (Belsomra) Prescription Maintenance High Long At bedtime Staying asleep Good for maintenance
Ramelteon (Rozerem) Prescription Onset Moderate Medium 30-60 min before bed Natural sleep onset Low dependency risk
Trazodone Prescription Maintenance High Long At bedtime Staying asleep Good for maintenance

Sleep Onset Issues

  • Racing thoughts at bedtime
  • Anxiety about sleep
  • Delayed sleep phase
  • Poor sleep timing
  • Evening alertness

Sleep Maintenance Issues

  • Early morning awakening
  • Multiple night wakings
  • Light sleep
  • Pain or discomfort
  • Environmental disruptions