Doctors Answers (3)
If you have a chronic problem (30 days or more) getting to sleep or maintaining sleep then a pill will never be the sole solution to your problem. Used chronically these types of medicines can be dangerous, linked to serious diseases and mortality and are addictive as well. A thorough history of the onset of your sleep problems and a psychosocial as well as health history can give clues as to all the contributing factors here. Non-pharmacologic treatment stategies as well as high resolution light therapy may be helpful in many cases. You should also watch your caffeine and alcohol intake when applicable. Trazodone is an antidepressant with some sedative properties and can be used transiently at moderate to high doses. Mirtazipine and seroquel are also used in this fashion.
Fibromyalgia and better sleep with medication is a difficult situation. Lyrica and it's cousin Neurontin can help help. Ambien and Lunesta may also be effective. You should have a sleep study though to rule a problem such as Sleep Apnea or Periodic Limb Movements of Sleep which actually may be causing your sleep problems.
Trazodone is not a a sleep medication. Despite its popular use as a sleep aide it is an antidepressant which has a side effect of causing drowsiness. It works for some but due to its long action it may take until noon the next day to clear the system causing daytime "fog". Often, when it only works for two hours, people will increase the dose which only enhances the next day hangover effect. Also, trazodone interferes with sleep staging such as suppressing REM sleep. REM sleep helps reduce pain. Better sleep medications are those approved by the FDA designed for sleep, not antidepressants, anticonvulsants, antipsychotics or over the counter "sleep aides" mostly for the some or all of the side effects of trazodone noted above. FDA approved sleep aides include benzodiazepine and so called "non benzodiazepine agents such as Lunesta and Ambien. Even these approved medications result in side effects in some persons. Therefore, they must be monitored by a physician. There are three medications approved by the FDA for fibromyalgia: Cymbalta, Lyrica and Savella. By improving pain, sleep may improve as well.
