Medications for Sleep Anxiety: Options and Risks

Common Prescription Classes

• Benzodiazepines (alprazolam, lorazepam, diazepam) – fast-acting, risk of dependence, tolerance, falls.
• Non-benzodiazepine hypnotics (zolpidem, eszopiclone, zaleplon) – shorter half-life, less dependence but still risk.
• Sedating antidepressants (trazodone, mirtazapine) – useful if comorbid depression/anxiety.

OTC Options

• Diphenhydramine (anticholinergic side effects, not for chronic use)
• Melatonin (circadian regulator, mild benefit)

Critical Advice

All sleep medications should be prescribed and monitored by a physician. CBT-I (cognitive behavioral therapy for insomnia) is first-line for chronic insomnia.