Ambien vs. Sonata: Important Differences, Interactions, and More

Ambien (zolpidem) and Sonata (zaleplon) are sedative medications that are used to help people sleep. They belong to the same class of medications, which is commonly referred to as “Z-drugs.”

Here, we’ll cover nine things you need to know about Ambien and Sonata.

Just keep in mind that Sonata is now only available as the generic version, zaleplon, in the U.S. But many people still refer to zaleplon as Sonata, because it's easier to say. Because of this, we’ll refer to zaleplon as Sonata throughout this piece.

1. Ambien and Sonata work the same way

Ambien and Sonata are commonly known as Z-drugs. They’re part of a group of medications called GABA agonists. GABA is a chemical in the body that has many functions, including having a calming effect on the brain.

Ambien and Sonata work by activating certain areas in your brain called GABA-A receptors. By activating these receptors, they help slow your brain down, which makes you sleepy.

2. There are some important differences between Ambien and Sonata

Ambien and Sonata have many similarities, which we discuss throughout this article. But they also have some differences.

Ambien and Sonata are recommended for different uses

Both Ambien and Sonata are FDA-approved to treat insomnia. The American Academy of Sleep Medicine (AASM) considers both prescription medications for sleep to be only minimally effective — but also minimally harmful with short-term use.

These medications are recommended for slightly different uses:

• Sonata can be taken at bedtime to help you fall asleep.

• Ambien can be taken at bedtime to help you fall asleep and stay asleep.

• There’s also a version of zolpidem (Intermezzo) that can be taken in the middle of the night to help you get back to sleep.

Ambien comes in multiple forms, including a long-acting one

Sonata only comes as an immediate-release capsule. But zolpidem comes in three different forms:

1. Ambien

2. Zolpidem extended release (Ambien CR)

3. Sublingual zolpidem (Edluar, Intermezzo)

If you have trouble staying asleep, versus trouble falling asleep, Ambien CR might be a more effective option for you.

But people taking Ambien CR are more likely to experience certain side effects. These include next-day drowsiness and impaired ability to do activities that require alertness. In fact, the FDA issued a warning about this in 2013.

People taking Ambien CR may also be more likely to have side effects like hallucinations, nausea, and dizziness.

Sonata is shorter-acting than Ambien

Sonata is the shortest-acting Z-drug. It works quickly, but it leaves the body quickly, too. This is why Sonata can be taken when you’re having trouble falling asleep, even after you’ve gone to bed. But Ambien should only be taken before bedtime and if you plan to sleep for at least 7 hours. If you get less than 7 hours of sleep after taking Ambien, you may wake up feeling drowsy or “hungover.”

Sonata has fewer medication interactions than Ambien 

Ambien is partially metabolized (broken down) by a major enzyme (protein) in the liver. Sonata is not as affected by this enzyme, so it’s less likely to have significant interactions.

Still, both medications have the potential to interact with other medications and substances. So don’t take Sonata or Ambien without asking your healthcare provider or pharmacist to check your medication list for interactions.

Of the Z-drugs, Sonata may be the least likely to be misused 

There’s some evidence that Sonata is less likely to be misused than Ambien and other Z-drugs. But this may also be because zaleplon is not as commonly prescribed as zolpidem, so there’s less information about its potential for misuse.

3. Ambien and Sonata should be taken on a short-term basis

The AASM considers Ambien and Sonata reasonable options for treating some aspects of chronic insomnia in adults. But the organization’s guidelines also state that these medications should only be recommended as long-term treatments for people who don’t see positive effects from (or don’t have access to) cognitive behavioral therapy (CBT).

CBT for insomnia is a type of therapy that may help people change behaviors or feelings that keep them from sleeping well. It’s considered the first-choice treatment option for managing insomnia.

Long-term treatment with Ambien or Sonata isn’t recommended because of the risks associated with Z-drugs. These risks include trying to do activities that can be dangerous while sleeping, such as driving. They also have a risk for dependence and misuse, especially if not taken as prescribed. As mentioned above, some Z-drugs can also reduce your ability to perform activities that require alertness (like driving) the following day.

4. Ambien and Sonata are controlled substances

Ambien and Sonata are classified as controlled substances. This means they’re more likely to cause dependence and misuse than non-controlled medications. And there are restrictions on how they can be prescribed and refilled.

5. It’s important to only take Ambien and Sonata as prescribed 

You should only take Ambien and Sonata as prescribed. When a person doesn’t follow a prescriber’s directions or takes medication they’re not prescribed, it can lead to a sedative use disorder. This is a medical condition in which a person has trouble controlling how much sedative substances they take.

Warning signs of sedative use disorder associated with Ambien and Sonata include:

• Experiencing cravings for these medications

• Continuing to take the medications even when it’s apparent their causing harm to the person’s personal or work life

• Giving up activities or responsibilities

• Physical dependence, which can present as tolerance and/or withdrawal symptoms

Tolerance is the need to take higher doses of a medication, like Ambien or Sonata, to get the same effect that you used to get with lower doses. Withdrawal is when you have physical or psychological symptoms after you stop taking, reduce the dose of, or are in between a dose of a medication, like a sedative. These symptoms may include stomach and muscle cramps, sweating, and shakiness. More serious symptoms, like seizures and confusion, can also occur.

Taking Ambien or Sonata exactly as prescribed and for the shortest amount of time possible can help prevent sedative use disorder. If you or someone you know struggles with substance misuse, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.

6. Z-drugs are not the same as benzodiazepines

Like Z-drugs, benzodiazepines (“benzos”) work by activating GABA-A receptors. But benzos bind to more areas on the GABA-A receptor than Z-drugs. This may be why benzos are prescribed to help with anxiety but Z-drugs aren’t.

Benzos and Z-drugs are both controlled substances. But the following risks may be more likely with benzos:

• Daytime drowsiness

• Confusion, trouble focusing, or memory problems

• A greater risk of dependence and misuse

Although benzos are thought to carry a higher risk of dependence and misuse, some research shows that this risk is more significant with Z-drugs than originally thought. Z-drugs are also more likely to cause abnormal sleep behaviors than benzos. This includes behaviors like sleep walking and driving while sleeping.

7. Ambien and Sonata shouldn’t be combined with other medications like opioids and benzos

Combining Z-drugs with other medications that slow down the brain can be dangerous. In severe situations, this can lead to an overdose.

Medications and substances that should not be taken in combination with Z-drugs include:

• Benzodiazepines like alprazolam (Xanax) and lorazepam (Ativan)

• Opioids like hydrocodone/acetaminophen and tramadol (ConZip, Qdolo)

• Alcohol

• Barbiturates like phenobarbital

• Tricyclic antidepressants like amitriptyline

Research shows that people taking an opioid in combination with a sedative are more likely to have an overdose than people taking an opioid alone. An overdose can be fatal and requires immediate medical attention.

8. Ambien and Sonata may not work as well for sleep as you think

In a large review that included almost 50 studies looking at Z-drugs for sleep, the results showed that Z-drugs shortened the time it took people to fall asleep, but only by about 13 minutes. So while Z-drugs may help you sleep, they may not have as significant of an effect as you hope. And the risks might outweigh the benefits.

Another study looked at over 150 people receiving Ambien 10 mg in combination with CBT or CBT alone for chronic insomnia. The study found that taking Ambien during the first 6 weeks of CBT did improve sleep. But those who continued on Ambien past the initial 6 weeks didn’t have better sleep than those who continued on CBT alone. This shows that long-term use of Ambien may not be as beneficial as CBT alone for insomnia.

Keep in mind: A 10 mg dose of Ambien may be higher than what’s appropriate for many people. Data has shown that taking Ambien 10 mg may lead to high levels of zolpidem in the blood for certain groups of people. This can result in an impaired ability to do activities the following morning.

9. If you’re over 65, it’s best to avoid Ambien and Sonata

The American Geriatrics Society (AGS) has a list of medications that are considered risky for older adults. Z-drugs are included on this list and should ideally be avoided by older adults. This is due to the risk of confusion, delirium, and falls with these medications.

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Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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