Often more casually referred to “benzos,” common drugs in this class include Valium (diazepam), Xanax (alprazolam), Ativan (lorazepam), and Klonopin (clonazepam). Doral (quazepam), Dalmadorm/Dalmane (flurazepam), Halcion (triazolam), ProSom (estazolam), are Restoril (temazepam) are those that are approved for the short-term treatment of insomnia.
How They Work
Benzodiazepines work to reduce anxiety and promote restful sleep by binding to the gamma-aminobutyric acid-A (GABA-A) receptors in the brain.
GABA is a neurotransmitter, a chemical messenger that travels between neurons. When these medications bind to GABA receptors, it calms the nervous system, inducing sedation, relaxing muscles, and helping to alleviate insomnia.
Side Effects
Benzodiazepines cause fatigue, mental fogginess, and altered motor control that can linger on through the morning after they are taken. This can affect driving safety, job performance, and decision-making. It is important to make sure you don’t take the medication too late in the evening if you have to drive in the morning.
Other common side effects include dizziness, amnesia, and difficulty thinking or reasoning. Talk to your healthcare provider if these side effects are bothersome as other medication can be used.
Warnings and Precautions
Take the drug you are prescribed exactly as directed. Never increase the dose or frequency without your healthcare provider’s OK.
Benzodiazepines should not be taken with alcohol or other sedating drugs. In particular, do not mix benzodiazepines with opioids, which are commonly found in prescription pain medications and cough syrups. Taking benzos with opioids can have serious side effects, including slowed or difficult breathing and even death.
Suddenly stopping benzodiazepines after a period of daily use can lead to seizures and other physical withdrawals. Discontinuation of a drug should be done under the care of a healthcare provider, who will typically develop a plan for you to safely taper off the medication.
Contraindications
Benzodiazepines should not be used for treating insomnia under certain conditions. Pregnant women, for example, should not use this medication unless approved by an obstetrician.
Benzodiazepine medications should be used with caution by people:
Who have depressionWith a history of alcohol, tobacco, or drug abuseWho are elderlyWith impaired breathing, liver, or kidney function
A Word From Verywell
Difficulty sleeping can have a negative impact on your daily life and mental health. While benzodiazepines can be an effective treatment for occasional insomnia, long-term daily use can cause physical dependence, putting you at risk for severe and possible life-threatening withdrawals upon stopping.
If you are currently taking benzos for sleep, talk to your healthcare provider about safely discontinuing their use and switching to other non-benzodiazepine medications for insomnia that may be safer for long-term use. In addition, cognitive-behavioral therapy has been shown to be effective in the treatment of insomnia.
