Sleep and Sedation Medicines
Sleep and sedation medicines are sometimes used to manage short-term insomnia, severe sleep disruption, or acute distress affecting sleep.
Sleep difficulties are common and may relate to:
- stress or anxiety
- shift work
- menopause
- chronic pain
- depression
- medication side effects
- lifestyle factors
Medication is usually considered only after assessment of underlying causes and sleep habits.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
Understanding Insomnia
Insomnia may involve:
- difficulty falling asleep
- waking frequently during the night
- waking too early
- non-restorative sleep
Long-term insomnia is rarely caused by a single factor. Assessment may include:
- mental health review
- medication review
- caffeine and alcohol intake
- hormonal considerations
- chronic pain assessment
Non-medication approaches are often first-line.
Learn more: Sleep Problems
Z-Drugs (Zopiclone and Zolpidem)
Z-drugs are short-acting sedative medicines used for severe short-term insomnia.
Common examples include:
- zopiclone
- zolpidem
They work by enhancing inhibitory neurotransmission in the brain.
Important considerations
- Intended for short-term use only
- Risk of tolerance and dependence
- Can impair next-day alertness
- May affect memory or coordination
Long-term use is not recommended.
Benzodiazepines
Benzodiazepines such as diazepam are sometimes used in specific clinical contexts but carry significant risks including:
- dependence
- tolerance
- withdrawal symptoms
- sedation and falls
These medicines are controlled drugs and require careful supervision.
They are not first-line treatment for chronic insomnia.
AccessGP does not prescribe controlled drugs, including Z-drugs such as zopiclone or zolpidem.
Instead, we focus on identifying and addressing the underlying causes of sleep disturbance. Sleep problems are often linked to stress, anxiety, hormonal changes, chronic pain, medication side effects, or lifestyle factors. A structured GP assessment allows us to review contributing factors, optimise existing medications, and discuss evidence-based non-pharmacological approaches such as sleep hygiene strategies or behavioural techniques. Where appropriate, we can also explore non-controlled medication options or address related conditions such as menopause, low mood, or anxiety that may be affecting sleep.
If sleep difficulties are affecting your wellbeing, a GP consultation can help you understand the safest and most effective next steps.
Melatonin
Melatonin is a hormone involved in regulating the sleep-wake cycle.
In adults, it may be considered in specific cases, such as:
- circadian rhythm disturbance
- shift work sleep disorder
- jet lag
Melatonin prescribing in the UK is usually specialist-led in children and selective in adults.
It is not a general long-term solution for insomnia.
Sedating Antidepressants
Certain antidepressants with sedating properties may be used where insomnia coexists with depression or anxiety.
Examples include:
- mirtazapine
- trazodone
These are not sleeping tablets in the traditional sense but may support sleep in selected cases.
Side effects and mental health context must be considered.
Antihistamines for Sleep
Some over-the-counter antihistamines have sedative effects.
However:
- Tolerance develops quickly
- Next-day drowsiness is common
- Anticholinergic effects may be problematic in older adults
They are not recommended as long-term sleep solutions.
Risks of Sedative Medicines
All sedative medicines carry risks, including:
- daytime drowsiness
- impaired driving
- increased fall risk
- cognitive impairment
- dependence
Sleep medicines should not be combined with alcohol.
Caution is particularly important in:
- those operating machinery or driving
- older adults
- people with respiratory conditions
- individuals with substance misuse history
Sleep hygiene and lifestyle tips
These practical habits can improve sleep quality over time, especially when used consistently for several weeks.
Tip: If insomnia persists for several weeks, or is linked with anxiety, low mood, menopause symptoms, or loud snoring and daytime sleepiness, a GP review can help identify the safest next steps.
Non-Medication Sleep Approaches
Cognitive behavioural therapy for insomnia (CBT-i) is considered first-line treatment for chronic insomnia.
Other measures include:
- consistent sleep schedule
- limiting screen exposure before bed
- reducing caffeine intake
- stress management
- addressing pain or hormonal factors
Medication is typically reserved for short-term crisis periods or specific clinical scenarios.
Frequently Asked Questions
1. Are sleeping tablets safe long term?
Most sleeping tablets are intended for short-term use only. Long-term use increases the risk of tolerance and dependence.
2. Can I get zopiclone prescribed online?
Zopiclone is a controlled drug and carries dependence risks. AccessGP does not prescribe controlled drugs.
3. Can menopause cause insomnia?
Hormonal changes during perimenopause and menopause can contribute to night waking, hot flushes, and fragmented sleep. Addressing underlying hormonal symptoms may improve sleep quality.
When to contact a GP
You should consider contacting a GP if:
- insomnia persists for several weeks
- sleep problems affect work or mood
- you rely on medication to sleep
- you experience withdrawal symptoms
- you snore loudly with daytime sleepiness
- you experience anxiety or low mood alongside sleep disturbance
Sudden confusion, severe daytime drowsiness, or breathing problems require urgent medical assessment.
Further Reading and Hub Links
Visit our Medication and Prescribing hub or browse more health topics in the AccessGP Knowledge Base.
If persistent sleep problems are affecting your quality of life, a GP can help guide you on the safest next step.
Last reviewed by Dr Zamiel Hussain, GMC registered GP
Updated: 14 February 2026