The Best Medication for Insomnia: Ambien, Sonata, or Lunesta? – GoodRx

How effective are these sleep drugs, anyway, and who do they work for best? It’s a straightforward question, but answering it isn’t so simple.

What do everyday people say?

Our friends at Iodine collected data about the real-life experiences of people taking these drugs. Data comes from hundreds of people sharing their experiences with Ambien, Lunesta, and Sonata, and rating these drugs in three respects:

First, younger people are less satisfied with sleep medications and find them to be more of a hassle in terms of side effects, and older people find sleep drugs to work better with fewer side effects.

And then there’s the bottom line: which drug works best.

Iodine data shows a clear preference for Ambien (zolpidem) in terms of overall satisfaction (“worth it” score). People taking Ambien say it’s worth it 67% of the time, while those taking Lunesta (eszopiclone) say it’s worth it 55% of the time, and those taking Sonata (zaleplon) say it’s worth it 42% of the time.

That still leaves a lot of people unsatisfied with these sleep medications, meaning lots of people are still going to struggle with insomnia—even with medications.

What do clinical studies say?

The above results show us that most of the people surveyed were satisfied with Ambien, but we still haven’t discussed dosage. That’s where clinical studies might be helpful. A study from Japan, for example, compared eszopiclone (Lunesta) to zolpidem (Ambien) and found that at doses of 2 mg or higher, these drugs were equally effective at helping people fall asleep. However, eszopiclone (Lunesta) was more effective in overall sleep efficiency (defined as the percentage of time people stayed asleep).

But, the effect depended entirely on dose. At lower doses of 1 mg, eszopiclone’s advantage disappeared. That’s important because the FDA reduced the recommended dose for eszopiclone from 2 mg to 1 mg, following reports that people on higher doses were less alert in the morning and at a higher risk of drowsiness during activities such as driving a car. This followed an earlier FDA adjustment in the recommended dose for zolpidem in women from 10 mg to 5 mg.

Keep in mind: Studies on sleep medications are usually done in sleep laboratories, which are poor proxies for real life, and they normally only include a small number of people over one or two nights because these types of studies are expensive. It’s difficult to apply the results from clinical trials to real life, and your best bet is to discuss treatment options with a healthcare professional and to keep your doctor in the loop as you try any new drug.

How much do these drugs cost?

At GoodRx, the lowest price for the generic version of Ambien, zolpidem, is around $8 for a prescription of thirty 10 mg tablets. The lowest GoodRx price for zaleplon (generic Sonata) is about $14 for a similar prescription. Eszopiclone (generic Lunesta) is around the same price.

Considering that people report greater satisfaction with zolpidem than the others, it looks like the cheapest drug might also be the one people prefer most. In other words, Ambien (zolpidem) offers the best bang for the buck.

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