Treatment Options for Insomnia

Canadian doctors recommend treatment for people struggling with sleep due to insomnia.

Insomnia is a medical condition that is defined as difficulty falling asleep, staying asleep, and/or waking up early and not being able to get back to sleep.

Treatment Options for Insomnia

Man in bed

Talk to your doctor about how sleep issues are affecting your daily life and your concerns about long-term health risks, and ask what treatment(s) are recommended for you.

Cognitive Behavioural Therapy for Insomnia (CBT-I)

A discussion-based approach that can help you identify and address thoughts, feelings, or behaviours that contribute to sleeplessness.

Dr. Mom discusses when to seek counselling with CBT-I
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Cognitive Behavioural Therapy for Insomnia (CBT-I)

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Sleep Hygiene

Sleep hygiene is another way to say “good sleep habits” that help improve sleep quality, such as reducing light and sound in your bedroom, or practicing a “wind down” activity. It also includes adjusting your lifestyle, like cutting down on caffeine and changing your exercise regimen. Know that sleep hygiene alone will not cure insomnia, so make sure to talk to your doctor about your sleep issues.

Start with some sleep hygiene tips from Dr. Mom
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Sleep Hygiene

Sleeping in bed
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Prescription Sleep Medicines

Prescription medicines may be recommended for people with insomnia. Talk to your doctor about the health risks associated with insomnia and ask if prescription sleep medicine is right for you.

Hypnotics

Dual orexin receptor antagonists (DORAs)

Orexins are substances that naturally occur in your body and bind to certain receptors in your brain to keep you awake. DORAs act as “wake blockers” and temporarily block these receptors. This may help you fall asleep faster and stay asleep longer.
Brand name example(s)
DayvigoGeneric nameLemborexant
Who and what it’s for
Adults who have trouble falling asleep and/or staying asleep (insomnia)
Maximum recommended treatment duration*
Not specified
Serious warnings and precautions
-
Brand name example(s)
QuviviqGeneric nameDaridorexant
Who and what it’s for
Adults who have trouble falling asleep and/or staying asleep (insomnia)
Maximum recommended treatment duration*
Not specified
Serious warnings and precautions
-

* Take your medication exactly as your doctor prescribed and for as long as they recommend.

Tricyclic antidepressants

This medication works by slowing down activity in the brain to allow sleep.
Brand name example(s)
SilenorGeneric nameDoxepin
Who and what it’s for
Used to treat adults who have trouble staying asleep
Maximum recommended treatment duration*
Not specified
Serious warnings and precautions
-

* Take your medication exactly as your doctor prescribed and for as long as they recommend.

Sedative hypnotics

Benzodiazepines

Benzodiazepines, known casually as “benzos,” work by telling your brain to release a certain neurotransmitter called gamma-aminobutyric acid (GABA). This neurotransmitter makes your nervous system less active, which can decrease the time required to fall asleep and the number of times you wake up during sleep.
Brand name example(s)
FlurazepamGeneric nameFlurazepam
Who and what it’s for
Used to treat adults for short-term insomnia. It should only be used when the effects of insomnia affect your daytime activities
Maximum recommended treatment duration*
Usually not more than 7–10 days

Use for more than 2 to 3 consecutive weeks requires a complete treatment re-evaluation by the doctor
Serious warnings and precautions
Addiction, abuse and misuse; withdrawal; use with opioids
Brand name example(s)
MogadonGeneric nameNitrazepam
Who and what it’s for
Used to treat adults for transient and short-term insomnia (usually not more than 7–10 days). It should only be used when the effects of insomnia affect a person's daytime activities. MOGADON does not treat the underlying cause of insomnia
Maximum recommended treatment duration*
Usually not more than 7–10 days

Use for more than 2 to 3 consecutive weeks requires a complete treatment re-evaluation by the doctor
Serious warnings and precautions
Addiction, abuse and misuse; withdrawal; use with opioids
Brand name example(s)
RestorilGeneric nameTemazepam
Who and what it’s for
Used to treat adults for short term treatment of insomnia. It should only be used when the effects of insomnia affect a person’s daytime activities
Maximum recommended treatment duration*
Usually not more than 7–10 days

Use for more than 2 to 3 consecutive weeks requires a complete treatment reevaluation by the doctor
Serious warnings and precautions
Addiction, abuse and misuse; withdrawal; use with opioids
Brand name example(s)
TriazolamGeneric nameTriazolam
Who and what it’s for
Used in adults to relieve the symptoms of transient and short-term insomnia. It should be used only in patients for whom their daytime activities are affected by their insomnia
Maximum recommended treatment duration*
Usually not more than 7–10 days

Use for more than 2 to 3 consecutive weeks requires a complete treatment re-evaluation by the doctor
Serious warnings and precautions
Addiction, abuse and misuse; withdrawal; use with opioids; memory loss

* Take your medication exactly as your doctor prescribed and for as long as they recommend.

Z-drugs (non-benzodiazepine hypnotics)

These medicines work by increasing the activity of a chemical in your brain called gamma-aminobutyric acid (GABA). This calms the brain which helps you go to sleep.
Brand name example(s)
LunestaGeneric nameEszopiclone
Who and what it’s for
Used in adults for short term treatment of insomnia. It should only be used when the effects of insomnia affect a person’s daytime activities
Maximum recommended treatment duration*
Usually not more than 7–10 days

Use for more than 2 to 3 consecutive weeks requires a complete treatment re-evaluation by the doctor
Serious warnings and precautions
Addiction, abuse and misuse; withdrawal; use with opioids; complex sleep behaviours
Brand name example(s)
ImovaneGeneric nameZopiclone
Who and what it’s for
Used in adults for short term insomnia. It should only be used when the effects of insomnia affect a person’s daytime activities
Maximum recommended treatment duration*
Usually not more than 7–10 days

Use for more than 2 to 3 consecutive weeks requires a complete treatment re-evaluation by the doctor
Serious warnings and precautions
Addiction, abuse and misuse; withdrawal; use with opioids; complex sleep behaviours
Brand name example(s)
SublinoxGeneric nameZolpidem
Who and what it’s for
Used in adults for short term insomnia. It should only be used when the effects of insomnia affect a person’s daytime activities
Maximum recommended treatment duration*
Usually not more than 7–10 days

Use for more than 2 to 3 consecutive weeks requires a complete treatment re-evaluation by the doctor
Serious warnings and precautions
Addiction, abuse and misuse; withdrawal; use with opioids; complex sleep behaviours

* Take your medication exactly as your doctor prescribed and for as long as they recommend.

Get Dr. Mom's list of questions to ask your doctor about prescription sleep medicines
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Over-the-Counter (OTC) Sleep Aids

Over-the-counter sleep aids are medicines that you can purchase from most pharmacies off the shelf without a prescription. There is a wide variety of over-the-counter health products available in Canada, both as single products and in combinations. Due to the number of available products on the market, this list is not comprehensive.

Medications could cause side effects and may not be suitable for everyone. Remember to talk to your doctor before starting a new product.

Antihistamines

Antihistamines block the action of the chemical called histamine, which works in the brain to promote wakefulness. Antihistamine medications can make you drowsy.
Brand name example(s)
ZzzQuil
Nytol
Sleep-ezeGeneric nameDiphenhydramine
Who and what it’s for
Used in adults and adolescents for the relief of occasional sleeplessness by people who have difficulty falling asleep. If sleeplessness persists for more than 2 weeks, contact your doctor
Maximum recommended treatment duration*
Not specified
Serious warnings and precautions
-

Melatonin

Melatonin is a hormone produced naturally in your body to help regulate sleep-wake cycles. Melatonin is widely available as a supplement and is the key ingredient in many OTC sleep aids.
Brand name example(s)
MelatoninGeneric nameMelatonin
Who and what it’s for
Can be used in adults to increase total sleep time and to address sleep issues like jet lag or shift work sleep disorder. If sleeplessness persists for more than 4 weeks, contact your doctor
Maximum recommended treatment duration*
Not specified

If sleeplessness persists for more than 4 weeks, contact your doctor
Serious warnings and precautions
-

Valerian

Valerian root is a traditional herbal medicine that contains chemical compounds that may impact the human brain and body. Currently, it is not fully understood which of those compounds affect sleep.
Brand name example(s)
ValerianGeneric nameValerian
Who and what it’s for
Used in adults to help reduce difficulty falling asleep, and for relief from the occasional sleepless night due to overwork, tiredness, or fatigue. If sleeplessness persists for more than 2 weeks, contact your doctor
Maximum recommended treatment duration*
Not specified

If sleeplessness persists for more than 2 weeks, contact your doctor
Serious warnings and precautions
-

* Take your medication exactly as your doctor prescribed and for as long as they recommend.

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Get Dr. Mom's list of Questions to Ask Your Doctor About Sleep Medicines
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If you are having persistent sleeplessness or insomnia, talk to your doctor about effective long-term treatment options.

Dr. Stephanie Liu

Dr. Mom

Dr. Stephanie Liu, aka Dr. Mom, is a family physician who delivers evidence-based health information. She has a special interest in sleep medicine and has partnered with SleepDebt.ca to bring you a series of informative blog posts and videos.
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