Accurate diagnosis is necessary for effective treatment. Various medical conditions and medications may contribute. Insomnia may be part of a existing mental health syndrome – such as depression and anxiety – or it may exist as a standalone condition. 

Treatment involves first addressing any underlying conditions. Cognitive Behavioral Therapy for Insomnia (CBTi) is considered the gold standard. However, sometimes this is not enough and medication may be needed. The pharmacology of insomnia is wide ranging, and Via Clinic offers nuance and direction in this regard. 

Medications for insomnia can be thought of in three different categories: 

• Non-controlleds. This category referrs to non-habit forming medications that have an effect to help a person feel more sleepy. Common examples would be the over-the counter medications diphenhydramine (Benadryl) or melatonin. Other, prescription strength options include trazodone, hydroxyzine, prazosin, quetiapine and gabapentin. As a class, these medications are typically safer to take regularly, but they risk morning grogginess. 
• Benzodiazepines. These are medications commonly used to treat anxiety, such as xanax, ativan, and klonopin. Benzodiazepine-like medications, including ambien, lunesta and sonata, also belong in this category. These medications are better studied for the treatment of insomnia, but they can induce dependency. As such, we recommend intermittent dosing as a best approach. 
• Orexin Receptor Antagonists. These are relatively new medications, which include belsomra, quviviq and dayvigo. They are separately categorized here because they more specifically target the biology of sleep, and they are promising treatments. Although these are also controlled medications, they do not share properties with the benzodiazepines. A major barrier is cost and brand-name status.