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Slumber in a Bottle

When sleep remains elusive—despite your best efforts to relax, resist caffeine, and stick to a regular snoozing schedule—it’s reassuring to know that medications can help.

Sometimes temporarily using a sleep medication can show you how much better you can feel with a good night’s sleep and encourage you to tackle your insomnia with serious sleep therapy.

Today’s sleep aids aren’t one size fits all: They can be tailored to your needs and spare you nasty side effects, such as next-day drowsiness. And with your doctor’s approval you don’t have to use it all the time. “Although some people find they need a sleep aid regularly, others just need help getting through occasional bouts of insomnia, so they use their medication only a few times a month,” says Dr. Neubauer. Talk with your doctor before you start these medications. Read the entire medication guide before taking. Here, match your sleep symptoms with the most effective formulas on the market.

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IF YOU NEED HELP…
Falling asleep or getting back to sleep: You regularly lie awake for more than half an hour trying to drift off, but once you’re asleep you’re out until morning, or you wake up in the middle of the night and can’t get back to sleep for the few hours before your alarm clock beckons

YOU MAY WANT TO TRY…
Sonata or Rozerem. They work fast but only stay in your system for two to three hours, so there’s practically a zero risk of next-day drowsiness—even if you take a pill in the middle of the night.

CAUTIONS
Not a good choice for people who wake up repeatedly during the night.

IF YOU NEED HELP…
Remaining asleep for a whole night: You want to stop experiencing frequent wakenings at night.

YOU MAY WANT TO TRY…
Ambien (lasts four to five hours). Ambien CR (lasts six to seven hours) or Lunesta (lasts seven to eight hours). These medications also help you fall asleep fast; they can be longer-lasting than Sonata or Rozerem so they help you stay asleep. Your choice depends on how much nightly sleep you need.

CAUTIONS
There have been rare medical reports of sleepwalking, night eating, sleep driving, and short-term amnesia in people using Ambien—some involved improperly mixing it with alcohol. Since Ambien CR and Lunesta last longer, they may cause daytime sleepiness if you don’t get seven to eight hours of uninterrupted sleep.

IF YOU NEED HELP…
Falling asleep because of anxiety: Putting your head on the pillow floods you with nonstop thoughts of work difficulties, family illness, etcetera.

YOU MAY WANT TO TRY…
An older sleep medicine in the benzodiazepine family, such as Halcion, Restoril, Valium, or Xanax. These sleep aids help release mental and muscle tension as well as induce sleep.

CAUTIONS
These drugs can trigger side effects such as drowsiness or headaches the next day. Addiction (you need ever-increasing doses to fall asleep) is a risk; with use for more than four weeks you need careful follow-ups to check for dependency.

IF YOU NEED HELP…
Falling asleep, but you have addiction concerns (You want to avoid anything that could ever be habit-forming).

YOU MAY WANT TO TRY…
Rozerem. Unlike other approved insomnia drugs, this is not classified as a controlled substance. Has shown no potential for abuse or dependence. Or a low dose of a sedating antidepressant (trazodone, doxepin) may be prescribed off-label for insomnia.

CAUTIONS
Rozerem won’t help you stay asleep; its sedating antidepressants can cause side effects such as dry mouth, blurry vision, palpitations, and constipation.

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