Drug	Daily dosage (mg)	Peak action (hours)	Half-life (hours)	Cost, 30 days (generic)*	Adverse effects and considerations	FDA approved?
Nonbenzodiazepines†
Zolpidem (Ambien)	5 to 10	0.5	2 to 3	$102	Abdominal pain, rebound insomnia; controlled-release formulation better for sleep maintenance; FDA pregnancy risk category B (not controlled-release formulation); CYP3A4-dependent metabolism	Yes
Zaleplon (Sonata)	5 to 10	0.5	1	103	Better for sleep maintenance; altered color perception; CYP3A4- dependent metabolism	Yes
Eszopiclone (Lunesta)	2 to 3	1	4 to 6	121	Unpleasant taste (8 to 24 percent), amnesia, hallucinations, worsening depression; CYP3A4-dependent metabolism	Yes
Melatonin receptor agonist
Ramelteon (Rozerem)	8 to 16	0.3	2 to 5	81	Suicidal ideation, dizziness, headache, increased prolactin levels; contraindicated with fluvoxamine and liver failure; CYP3A4-, CYP1A2-, and CYP2C9-dependent metabolism	Yes
Antihistamines
Diphenhydramine (Benadryl)	25 to 50	1 to 3	8	5 (1 to 3)	Anticholinergic,‡ CNS depression/stimulation; FDA pregnancy risk category B	Yes
Doxylamine (Unisom)	12.5 to 25	2 to 3	10	8	Anticholinergic, CNS depression/stimulation; FDA pregnancy risk category A	Yes
Hydroxyzine (Vistaril)	25 to 100	2	3 to 7	37 (9 to 21)	Anticholinergic, CNS depression/stimulation	No
Antidepressants
Amitriptyline	25 to 100	2 to 4	17 to 40	21 (2 to 4)	Anticholinergic, morning sedation, daytime somnolence, accidents, cardiac toxicity, sexual dysfunction, serotonin syndrome (SSRI interaction), exacerbates restless legs syndrome and periodic limb movement; CYP2D6-dependent metabolism	No
Trazodone (Desyrel)	50 to 150	0.5 to 2	8	68 (9 to 13)	Same as above	No
Mirtazapine (Remeron)	15 to 45	1.2 to 1.6	20 to 40	104 (81 to 83)	Anticholinergic, dyspnea, edema, hyper- or hypokinesia, increased appetite	No
					Rare: facial edema, delusions, hallucinations, seizures, abdominal pain, back pain, agranulocytosis
Benzodiazepines§
Triazolam (Halcion)	0.125 to 0.5	1 to 2	1.5 to 5	$42 (18 to 21)	Rapid onset, short half-life; anterograde amnesia, rapid eye movement sleep rebound; CYP3A4-dependent metabolism	Yes
Estazolam	1 to 2	2 (0.5 to 6)	10 to 24	43 (18 to 27) for 1 mg nightly	Rapid onset, intermediate half-life; daytime sleepiness	Yes
Temazepam‖ (Restoril)	7.5 to 30	1.2 to 1.6	3.5 to 18.4	99 (20 to 21) for 15 mg	Medium onset, intermediate half-life; daytime sleepiness, less effective sleep induction	Yes
Herbs and supplements
Melatonin	0.5 to 10	1	0.5 to 2	3 to 5 for 3 mg	Sleep disruption, daytime fatigue, headache, dizziness, irritability	No
Valerian root	200 to 1,000	1	Not known	2 to 3 for 450 mg	Daytime sedation, hepatotoxicity	No