Sleeping Pills for Insomnia: What You Should Know About Lunesta, Ambien, and Sonata
Key takeaways:
Lunesta (eszopiclone), Ambien (zolpidem), and Sonata (zaleplon) are non-benzodiazepine medications (“z drugs”) used to treat difficulty sleeping, or insomnia.
These z-drugs are similar in how they work and their expected side effects. They’re also considered controlled substances, which means they have a potential risk for dependence and misuse.
All three medications have a generic form available, which helps with accessibility. Talk with a healthcare professional if you’re considering these medications, or have questions about them.
Table of contents
Every evening, millions of U.S. adults take a prescription medication to help them get to sleep and stay asleep. These are often a generic version of Lunesta (eszopiclone), Ambien (zolpidem), or Sonata (zaleplon). These three medications are non-benzodiazepine sedative hypnotics, or “z-drugs,” that help with sleep by causing a hypnotic, calming effect.
These prescription sleep medications are also controlled substances, meaning they can be habit-forming (cause dependence) and lead to misuse. But they were developed with the intention to have fewer side effects and less potential for dependence than benzodiazepines.
So, exactly how safe are these sleep medications? Keep reading to learn what studies say about Lunesta, Ambien, and Sonata, including common doses and side effects to consider.
Lunesta
Lunesta is taken orally just before bedtime. The usual dosage is 1 mg, 2 mg, or 3 mg once daily. The FDA recommends starting at the lowest dose (1 mg) and only going up if needed. This is because of the risk of being drowsy the next day with higher doses.
While Lunesta seems to last longer than Ambien or Sonata, experts recommend that you should be able to get at least 7 to 8 hours of sleep before taking any of these medications.
Lunesta side effects
Common Lunesta side effects include:
Unpleasant taste
Headache
Dizziness
Dry mouth
Rash
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Other side effects of Lunesta can include:
Abnormal thinking, including hallucinations
Behavioral changes
Feeling tired or sleepy the next day
Anxiety or depression
Respiratory infection
Ambien
Ambien is usually taken orally as a 5 mg to 10 mg dose once a day, just before you go to bed. Ambien CR (zolpidem ER), the extended-release version of zolpidem, is taken at a dose of 6.25 mg or 12.5 mg daily just before bedtime.
However, the FDA recommends taking a 5 mg dose (6.25 mg dose for Ambien CR) as the starting dose because of the risk of drowsiness the next day after taking a dose.
Ambien side effects
Common Ambien side effects include:
Nausea
Dizziness
Diarrhea
Headache
Other side effects of Ambien can include:
Abnormal thinking, including hallucinations
Behavioral changes
Feeling tired or sleepy the next day
Depression
Sonata
Sonata is typically taken orally as a 5 mg, 10 mg, or 20 mg dose. Again, it’s best to take it right before bedtime.
Sonata side effects
Common Sonata side effects include:
Headache
Dizziness
Nausea
Abdominal pain
Other side effects of Sonata can include:
Abnormal thinking, including hallucinations
Behavioral changes
Feeling tired or sleepy the next day
Depression
Risks of taking sleeping pills
Although rare, Lunesta, Ambien, and Sonata come with a higher risk of sleep behaviors than other sleep medications. Behaviors like sleepwalking and driving while asleep are more common in people who take these medications. These can be dangerous — and even lead to death.
That’s why these medications come with a boxed warning for these behaviors, which is the FDA’s most serious medication warning.
Talk to a healthcare professional about sleeping pills
Studies on sleep medications are often performed in sleep laboratories. They may not be an accurate representation of how these sleeping pills work in real life. They may only include a small number of people, tested over one or two nights as part of the study design.
Your best bet is to discuss treatment options for insomnia with a healthcare professional and to keep them in the loop as you try any new medication.
Frequently asked questions
There isn’t one strongest or best prescription sleep medication. However, some research suggests that orexin receptor antagonist (ORA) medications, such as Dayvigo (lemborexant) and Belsomra (suvorexant), may be more effective than z-drugs. ORAs may help you get to sleep faster and stay asleep longer compared to other sleep medications.
You should avoid certain things while taking sleeping pills. Namely, don’t drink alcohol and take sleep medications on the same day. This combination can be dangerous, habit-forming, and increase your risk of unintended sleep behaviors. These include sleep driving and performing other dangerous tasks without being fully conscious. Don’t take your sleep medication several hours before you plan to go to sleep, either; take it shortly before bedtime.
The bottom line
Lunesta (eszopiclone), Ambien (zolpidem), and Sonata (zaleplon) are three non-benzodiazepine medications (“z drugs”) that are used to help with sleep. These three medications are similar in terms of side effects and how they work. The right choice for you will likely come down to your symptoms, medical history, and which one is most affordable.
If you think you might need medication to help you sleep, talk with a healthcare professional. They can help you weigh the benefits and risks of each and help you find what may work best for you.
Why trust our experts?
References
A-S Medication Solutions. (2024). Zolpidem tartrate - zolpidem tartrate tablet, film coated [package insert].
Lie, J. D., et al. (2015). Pharmacological treatment of insomnia. P & T.
McElroy, H., et al. (2021). Comparative efficacy of lemborexant and other insomnia treatments: a network meta-analysis. Journal of Managed Care & Specialty Pharmacy.
PD-Rx Pharmaceuticals. (2024). Zaleplon- zaleplon capsule [package insert].
Reuben, C., et al. (2023). Sleep medication use in adults aged 18 and over: United States, 2020. Centers for Disease Control and Prevention.
U.S. Food and Drug Administration. (2016). FDA drug safety communication: FDA warns of next-day impairment with sleep aid Lunesta (eszopiclone) and lowers recommended dose.
U.S. Food and Drug Administration. (2018). Questions and answers: Risk of next-morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist).
U.S. Food and Drug Administration. (2022). FDA adds boxed warning for risk of serious injuries caused by sleepwalking with certain prescription insomnia medicines.
U.S. Food and Drug Administration. (2024). Taking Z-drugs for insomnia? Know the risks.
Yue, J., et al. (2023). Efficacy and tolerability of pharmacological treatments for insomnia in adults: A systematic review and network meta-analysis. Sleep Medicine Reviews.
