Doghramji: “In terms of supplements, the one that’s probably most researched is melatonin, but there’s no good evidence on what dose should be used. I typically recommend a low dose close to bedtime, something like 1 milligram or so, maybe a half hour before going to bed. Some people will take that, and nothing happens. For those, I recommend a gradual dose increase up to 3 milligrams. … There are three medications which are meant to not only help you fall asleep but stay asleep, and those are Ambien extended release or Ambien CR (generic name: zolpidem), Lunesta (generic name: eszopiclone) and Belsomra (generic name: suvorexant). They’ve been shown in patients who have difficulty with sleep initiation or maintenance to actually improve the quality of sleep. One of their major negatives as a collective group is that they can cause daytime sedation. Secondly, all three medications have a Drug Enforcement Administration scheduling. What that means is they may have a tendency for an increased likelihood for abuse and diversion. Thankfully, that tendency is not that high with these drugs. Long-term studies have shown that people tend not to escalate the use of these drugs in general.” These drugs are typically not recommended for people with a history of drug abuse.
Kushida: “There aren’t any medications that I would recommend unless first being evaluated by a sleep specialist. The best treatment for chronic insomnia would be cognitive behavorial treatment for insomnia.”