Lunesta, Ambien, & Sonata:
Three Z-Drugs To Get You Sleeping Again

What Are Z-Drugs?

Z-Drugs (Zaleplon, Zolpidem, and Eszopiclone) consist of three prescription medications that can help you overcome insomnia.

In short:

They’re used to help you catch some zzz’s when your sleeplessness is persistent.

These three drugs make up a class of medications that are known as sedative-hypnotics, and they work by slowing the activity in your brain to help you drift off to sleep.

Other than insomnia, sedative-hypnotics can also be used as muscle relaxers, anesthetics, and anticonvulsants.

Though similar in how they work and the effects they have on your sleep, there are slight differences between each of the three which we’ll explore in more depth in the following sections.

Z-Drugs Vs. Benzodiazepines

Z-Drugs are far from being the only type of medication used to help you get more rest.

Another class of medications known as Benzodiazepines is also sometimes prescribed by doctors in the instance someone is suffering from insomnia and hasn’t been able to get relief from other options.

They’re also often prescribed for other conditions including anxiety, muscle spasms, seizure disorders, and anesthesia.

Both Z-Drugs and Benzodiazepines do have a few similarities. Notably, both classes of medications work by quieting activity in your brain to help you drift off to sleep.

However, as of recent, Z-Drugs have been shown to be more effective when it comes to helping you fall asleep faster.

With Benzodiazepines, you might experience rebound insomnia, a phenomenon where your sleep problems return once you’ve finished taking the medication. They also carry a very high risk of withdrawal symptoms.

Finally, some research has shown that some benzodiazepines are easier to develop a tolerance for. This means that someone may need to increase their dose to continue to receive the benefits of the drug. This can lead to some concerns for dependence.

While Z-Drugs may cause some of these same side effects, they tend to be lesser due to the fact that they leave the body more quickly.

Can Z-Drugs Be Abused?

When used properly, Z-Drugs can get you back to sleep, particularly when other methods haven’t worked in the past.

But with that in mind, there are a few things to be aware of as Z-Drugs do have the potential to be habit-forming.

All Z-Drugs carry an FDA Black Box Warning. This is the most powerful warning issued by the agency.

These warnings bring attention to these drugs’ risks, including those that can lead to injury or even death.

The FDA has also added a Contraindication Warning. This warning is meant for anyone who has experienced a complex sleep behavior in the past. These are actions that you would normally take when you’re awake while you’re still asleep without having any memory of doing so. They may include eating, walking, or talking. But they can also lead to much more dangerous behaviors like driving or operating a hot stove.

With these risks in mind, it’s imperative that you speak with a doctor before you give any Z-drug a try. In the instance your doctor does think a Z-drug prescription is right for you, it’s important you take it exactly as prescribed and to not stop the prescription without first consulting with your doctor.

Last but not least, Z-drugs should never be mixed with alcohol or other substances. Be sure to let your doctor know about any other prescriptions, over-the-counter medications, or supplements you’re taking so they can help you minimize your risks and any side effects.

What’s Lunesta?

Lunesta, also known as Eszopiclone, is one of the three Z-Drugs.

It may be prescribed to you alone or along with other medications. In most cases, however, your doctor will recommend additional non-medicinal treatments in addition to your prescription. This can include Cognitive Behavioral Therapy or sleep hygiene practices.

Lunesta has been shown to improve sleep latency, the amount of time it takes you to fall asleep. This means it can be an effective option for those who find themselves suddenly feeling very awake when they should be drifting off to sleep.

For many, Lunesta can help you fall asleep faster, get you a full night of rest, and prevent interruptions to your sleep throughout the night.

How Does Lunesta Work?

As we mentioned above, Z-Drugs, including Lunesta, work by affecting the chemicals in your brain that may be unbalanced, causing insomnia.

It’s intended as a short-term solution and should only be prescribed for 1-2 weeks.

Once prescribed, Lunesta should be taken right before bed on an empty stomach.

The dosage you’re prescribed depends on several variables including your age, your general health, and any other medications you’re currently taking.

In many cases, your doctor will start you off on a low dose of 1 mg on the first night. From then on, your dosage will likely fall in between 1-3 mg once a day.

Your doctor may start to decrease your dose toward the end of your treatment. Weaning off of the medication rather than stopping can help avoid unwanted withdrawal symptoms.

In most cases, the maximum dose prescribed is 3 mg once per day.

Because Lunesta is known to be longer acting, another factor your doctor may take into consideration when determining the right dosage for you is how alert you need to be the morning following your dose. A higher dose can mean you’re not as alert as you think you are, and therefore may put you at risk for injury or accidents.

In many cases, your doctor will recommend you start your first couple of doses on days when you don’t have to be up early and don’t have to drive.

Regardless of the dosage written for you, it’s important to take it exactly as it’s been prescribed to you.

Additionally, Lunesta is known to be fast-acting. So only take it right before bed and only if you have a full 7-8 hours for sleep.

Once you’ve finished your treatment with Lunesta, it’s possible you’ll experience insomnia rebound - or a return of your sleep troubles. This is completely normal and for most people, their sleep troubles go away after 1-2 nights.

Your chances of returning to normal, healthy sleep are improved with CBT-i and sleep hygiene practices.

What Are Lunesta’s Side Effects?

Lunesta does carry a risk of side effects. It’s important to give your doctor a full medical history so they can provide you a treatment that will help minimize as many of these as possible.

Some of the most common side effects experienced by patients taking Lunesta include:

• Drowsiness during the daytime
• Dry mouth
• Dizziness
• Grogginess or a “hangover”-type feeling
• Trouble focusing
• Unpleasant taste
• Dry mouth
• Stomach pain
• Nausea

More serious side effects may include:

• Anxiety or nervousness
• Depression
• Memory loss
• Changes in mood or behavior
• Hallucinations
• Complex sleep behaviors

If you experience any of these side effects, be sure to contact your doctor right away. Your doctor may work with you by adjusting the dosage or opting for a different treatment altogether.

This is not an exhaustive list of all possible side effects. Please be sure to read your doctor’s treatment plan and the drug pamphlet included with your prescription for a full list of potential side effects.

Finally, though rare, there is a potential for an allergic reaction to Lunesta. Please seek help from your doctor right away if you notice any signs of an allergic reaction, including:

• Itchiness
• Trouble breathing
• Rash
• Swelling to your face, tongue or throat

It’s important that you not drive or do any other activities in the morning until you’ve learned how you react to Lunesta. In some cases, you may be more drowsy than you realize.

Who Shouldn’t Use Lunesta?

Though Lunesta has been found to relieve the symptoms of insomnia, it’s not the right treatment option for everyone.

Be sure to give your doctor a full medical history and let them know if you have a history of:

• Other sleep disorders, including sleep apnea or restless leg syndrome
• Kidney disease
• Liver disease
• Breathing problems
• Mood disorders
• Muscle disease
• History of substance abuse
• History of complex sleep behaviors, including sleepwalking

Also, be sure to let your doctor know if you’re pregnant or currently breastfeeding.

You should also provide your doctor with a complete list of all prescriptions, over-the-counter medications, and supplements you’re currently taking. Be particularly sure to let your doctor know if you’re taking:

• Rifampin
• Ketoconazole
• Antidepressants
• Anti-anxiety medications
• Pain medications
• Muscle relaxers
• Seizure medications

Lunesta should not be prescribed to anyone under 18 years old. This drug may not be appropriate for older patients as it can be stronger and they may be at a higher risk of negative side effects.

A doctor will determine whether or not this medication is right for you.

What’s Ambien?

Ambien, also known as Zolpidem, is a second Z-drug option available for those who are suffering from symptoms of insomnia.

Similar to Lunesta, it may be prescribed as a solitary treatment or in addition to other treatments. Most doctors will use Ambien alongside CBT-i or sleep hygiene recommendations to improve your chances of long-term improvement.

Ambien is available in both an immediate-release form and an extended-release form. Your doctor will determine which of these is appropriate for you based on how your insomnia affects you.

In some cases, Ambien can help you stay asleep longer making it an effective choice for those who experience regular interruptions to their sleep or find they tend to wake back up before getting a full night of rest.

How Does Ambien Work?

Much like Lunesta, Ambien helps you fall asleep and stay asleep by quieting activity in your brain and promoting a calming effect.

Ambien is usually prescribed for 1-2 weeks and is meant to help provide short-term relief for insomnia.

It’s used by taking the prescription just before your bedtime and on an empty stomach.

The dosage your doctor prescribes will depend on your age, your gender, your general health, and a few other factors. Your dosage will also depend on whether you’re taking the immediate-release or extended-release version.

Typically dosage will be:

• Immediate-release:
  • 5 - 10 mg once per day
• Extended-release:
  • 6.25 - 12.5 mg once per day

Your doctor will likely opt to start you out on a lower dose to see how the medication affects you and to minimize side effects. Additionally, your doctor may have you try the immediate-release tablet first and may opt to switch to the extended-release tablet.

Similar to Lunesta, your doctor will also take other factors into consideration and will recommend you begin your treatment on days when you don’t have to be anywhere and you don’t have to do any activities like driving.

Be sure to take Ambien only if you can dedicate a full 7-8 hours to sleep. Additionally, make sure you take Ambien right before you plan on going to bed.

What Are Ambien’s Side Effects?

Ambien does carry a risk of side effects and has been known to have lingering effects the next morning. Some people report having trouble staying alert in the morning after taking Ambien.

The risk of experiencing this side effect is increased if you drink alcohol or use certain other medications while taking Ambien. Because of this, you should never use alcohol while taking Ambien. Additionally, be sure to alert your doctor of all other medications you’re taking, prescription or otherwise.

It’s also important to seek medical attention if you experience any signs of an allergic reaction. Look out for:

• Swelling in the nose, throat or face
• Rash or hives
• Trouble breathing
• Nausea or vomiting

The most common side effects experienced after taking Ambien are:

• Drowsiness during the day
• Lightheadedness
• Dizziness
• Headache
• Diarrhea

Let your doctor know if you experience any of these. Your doctor may be able to help alleviate by adjusting your dose or choosing an alternative treatment route altogether.

More serious side effects are also possible. Be sure to alert your doctor if you find yourself feeling any of the following:

• Change in mood or behavior, including agitation or aggressiveness
• Anxiety
• Depression
• Hallucinations
• Memory loss
• Feeling like you might faint
• Complex sleep behaviors

It’s important to note this list is not exhaustive. Once you’ve been prescribed Ambien, you should discuss all possible side effects with your doctor as well as review your treatment plan and pamphlet included with the medication.

Never drive or participate in any other activities after taking Ambien until you know how the drug affects you. Only take Ambien when you can sleep for 7-8 hours.

Who Shouldn’t Use Ambien?

It’s important to speak with your doctor about what sleep treatment is right for you, and Ambien is no exception.

When you meet to discuss your potential options with your doctor, you’ll need to review your full medical history and draw any attention to:

• Other sleep disorders, including sleep apnea or restless leg syndrome
• Liver or kidney disease
• Breathing disorder, including sleep apnea
• History of mental illness, including depression
• History of substance abuse
• History of muscle disorders, including myasthenia gravis

You should also be sure to let your doctor know if you’re pregnant or currently breastfeeding.

Next, make sure you have prepared a full list of all medications you currently take. Ideally, this list should include prescriptions, over-the-counter drugs, and supplements.

Particular medications to let your doctor know about include:

• Other sleep medications
• Pain medications, including opioids
• Muscle relaxers
• Anti-anxiety medications
• Anti-depression medications
• Seizure medications
• Allergy medications
• Cough or cold medicine

Other medications may cause Ambien to be less effective so be sure to put together a full list.

A doctor will determine whether or not this medication is right for you.

What’s Sonata?

Sonata, also known as Zaleplon, is the third medication included in the Z-Drug category. Like it’s Lunesta and Ambien counterparts, it’s used as a short-term solution for treating insomnia.

To improve the effectiveness of your treatment, your doctor will likely pair Sonata with CBT-i exercises and sleep hygiene improvements. This will also increase your likeliness to long-term improvement.

Research has been shown this medication may help those who have trouble falling asleep.

However, compared to Ambien, Sonata is faster acting but also tends to leave the body quicker. So for those who experience interrupted sleep, Sonata may not be an effective option.

With that in mind, because Sonata does tend to leave the body more quickly, the changes of common side effects like grogginess the next day are sometimes minimized.

How Does Sonata Work?

Like Lunesta and Ambien, Sonata is a sedative-hypnotic, meaning it will quiet your brain and help you fall asleep.

Also similarly, Sonata is intended for short-term use; Sonata should never be prescribed for longer than a period of 1-2 weeks.

Sonata is taken at bedtime on an empty stomach, but only when you have 7-8 hours for a full night of sleep. Your doctor will also likely recommend you start your treatment on a weekend when you have a greater chance of sleeping in and don’t have to drive anywhere in the morning.

Your dosage will be personalized for your needs and will be determined by a number of factors.

Generally, a dose between 5mg - 20mg is provided.

Similar to the other two Z-Drugs, your doctor will likely start you off on a lower dose and increase if needed. Additionally, your doctor will likely recommend weaning you off by slowly decreasing your dosage at the end of your treatment to help avoid withdrawal symptoms.

What Are Sonata’s Side Effects?

Sonata does carry the potential for side effects, many of which are similar to both Lunesta and Ambien.

The most common side effects experienced include:

• Drowsiness
• Headache
• Achy muscles
• Stuffy nose

These side effects do not generally require immediate medical attention; however, your doctor may opt to make adjustments to your treatment if you experience these.

More serious side effects to be aware of include:

• Changes to your mood
• Confusion
• Hallucinations
• Unusual behavior, including complex sleep behaviors
• Thoughts of suicide

If you experience these or any other side effects, be sure to let your doctor know as soon as possible.

This list of side effects is not exhaustive. So before taking your first dose of Sonata, be sure to discuss all potential side effects with your doctor and take the time to review your treatment plan and drug manufacturer’s pamphlet.

Finally, an allergic reaction to Sonata is possible. Seek immediate care if you begin to show signs of an allergic reaction. These may include:

• Hives or a rash
• Difficulty breathing
• Nausea or vomiting
• Swelling in your face, lips, tongue or throat

To lessen your chances of experiencing side effects, be sure to take your prescription as directed. Additionally, do not use Sonata while under the influence of alcohol.

Who Shouldn’t Use Sonata?

Sonata can be effective for those who have trouble falling asleep at night, but it may not be the best treatment option for everyone.

Your doctor will help you determine the best treatment path forward for you.

To help them do this, you need to provide them with a full and up-to-date medical history. If you’re considering a Sonata prescription, please be sure to bring attention to any of the following:

• Other sleep disorders, including sleep apnea or restless leg syndrome
• Liver problems
• Irregular blood pressure
• Breathing problems, including asthma
• History of mental illness, including depression
• History of substance abuse

Also, be sure to let your doctor know if you’re pregnant or currently breastfeeding. Finally, be sure to let your doctor know if you use marijuana.

Your doctor will also need to be aware of all medications you’re taking in order to make a complete recommendation. Be sure to bring their attention to any of the following:

• Pain medication, including opioids
• Other sleep medications
• Muscle relaxers
• Anti-depression medications
• Anti-anxiety medications
• Seizure medications
• Melatonin
• Cold or cough medications
• Allergy medications

Conclusion

Now that you have a better understanding of the three Z-Drugs (Lunesta, Ambien, and Sonata), how do you know which is right for you?

In short, there’s no one best option for everyone. Doctors make their recommendation for treatment on a case-by-case basis and will discuss the best treatment path forward for you based on your personal needs, your experience with insomnia, your general health, and several other factors.

As discussed above, all three of these options can be used on their own or in addition to other treatments; however, most doctors will recommend any Z-Drug be taken on top of cognitive behavioral therapy and sleep hygiene.