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Lunesta vs. Ambien: Two Short-term Treatments for Insomnia

Finding Peace of Mind

A lot of things can make it difficult to fall asleep or stay asleep. Trouble falling asleep consistently is known as insomnia. In many cases, the condition works itself out without the use of drugs. But if insomnia is routinely keeping you from getting restful sleep, you should see your doctor. Insomnia may be a sign that you have a medical condition. Treating the underlying condition could clear up your insomnia. However, if a lack of sleep is interfering with your ability to function, your doctor may recommend a sleeping pill for short-term use.

Continue reading to learn more about Lunesta and Ambien, two commonly prescribed medications that can help you get a good night’s sleep.

Lunesta and Ambien: What They Do

Lunesta is a brand name for eszopiclone. Ambien is a brand name for zolpidem. Both of these medications belong to a class of drugs called sedative-hypnotics. These powerful drugs decrease brain activity and produce a sense of calm and they can help you fall asleep. Both medications are intended for short-term use, and either one can become habit-forming.

While they both help you fall asleep, eszopiclone has a longer action in the body and may be more effective in helping you stay asleep. However, zolpidem has a second version, an extended-release tablet, which may help you stay asleep longer.

Understand the long- and short-term risks of sleep deprivation »

Who They’re For — Who They’re Not For

These medications are usually prescribed to adults who have trouble sleeping. It’s important that you see your doctor for a full evaluation of your sleep difficulties because you could have problems getting to sleep or problems staying asleep. The treatment for one kind of sleep problem might not be the right treatment for the other.

Your doctor will evaluate your sleep patterns as well as your current sleep difficulties. You may be able to improve your sleep with improved sleep hygiene, which is keeping the same bedtime every night, avoiding naps, and limiting caffeine and alcohol, which can both disrupt normal sleep.

If you require medication to treat your sleep problems, you may be able to take it only occasionally to break the cycle of sleeplessness. If medication does not work, you could need evaluation by a sleep specialist to improve your sleep.

If you have depression, some sleep medications can make your depression worse. Talk to your doctor about your depression before taking any sleep medication.

Eszopiclone and zolpidem are not recommended for children, as they could have more unpredictable emotional side effects. Recently, dose reductions have been recommended for women and older adults, as they may have more serious side effects or their bodies may process the drugs more slowly.

Be sure to give your doctor a complete medical history. If you have chronic obstructive pulmonary disease (COPD), sleep apnea, or have a history of substance abuse, these medications may not be right for you. Your doctor will want to monitor you closely.

Forms and Strengths

Eszopiclone is available in 1 mg, 2 mg, and 3 mg tablets.

Zolpidem is available in 5 mg and 10 mg immediate-release tablets. It’s also available in 6.25 mg and 12.5 mg extended-release tablets.

Dosing

With either medication, your doctor will probably start you on a low dose to keep the side effects to a minimum. The dosage will be based on your gender, age, and other factors. Your doctor can adjust the dosage up or down as needed. Recently, the recommended doses of these sleep medications have been decreased for women and seniors, due to side effects and daytime impairment.

For eszopiclone, most adults can start with 1 mg. If that doesn’t work, the dose can be raised incrementally.

For zolpidem, women can generally start at 5 mg and men start at either 5 mg or 10 mg taken at night, with at least eight hours available for sleep following the dose. When taking the extended-release version, women start at 6.25 mg and men can be started on either 6.25 mg or 12.5 mg. Many doctors will first try prescribing the fast release form, to see if the drug agrees with the person and later switch to the extended-release version if needed.

Many doctors prescribe limited amounts of sleeping medication, to help patients learn to break the cycle of sleeplessness, and avoid becoming dependent on the drug.

How and When to Take Them

Both of these drugs should be taken just before you’re ready to go to bed. It’s very important that you don’t take them unless you have time for seven or eight hours of sleep. Also, they won’t work well if you eat a heavy or high-fat meal before taking them. It’s best to take them on an empty stomach.

Zolpidem’s extended-release tablets must be swallowed whole. Chewing or breaking them is dangerous.

It’s important to read and follow label directions carefully.

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Cost Considerations

How much you’ll pay for a prescription drug can vary depending on where you live, your pharmacy, and your health insurance plan. Generally speaking, generic versions are significantly less expensive than brand name versions. Lunesta and Ambien are brand name drugs.

Potential Side Effects of Each

Common side effects of both drugs are lightheadedness and dizziness. Another is continued sleepiness during the day. If you feel lightheaded or sleepy, don’t drive or use potentially dangerous machinery. If you need to continue using sleep aids, talk to your doctor about the side effects. Your dose may need some adjusting.

Warnings and Interactions

As with any medication, it’s possible to have an allergic reaction to either medication. If you break out in hives, or have swelling of the tongue or throat, seek medical help immediately.

Tell your doctor if you’re pregnant or nursing. Both of these drugs are not routinely recommended during pregnancy. Both could cause central nervous (CNS) system depression in your baby. Your baby could also be at risk of withdrawal after birth, if you have been taking zolpidem. Both drugs pass through the breast milk, which could also affect your baby.

Both of these medications depress your CNS and can impair your thinking and physical abilities.

Impaired Function

It’s dangerous to take sleeping pills if you aren’t able to stay in bed for a full night. The drugs are still active in your system even if you stay awake. You may be at risk of memory loss, hallucinations, and poor motor skills. Some of these effects may extend into the next day. 

Dependency and Withdrawal

If you take high doses or use sleeping pills for more than 10 days, you may develop a physical dependency. That means your regular dose will not be as effective as it once was. You’re at greater risk of developing a dependency if you’ve had substance abuse problems in the past.

Stopping suddenly can lead to withdrawal symptoms. Symptoms of withdrawal include shakiness, nausea, and vomiting. To avoid withdrawal symptoms, speak to your doctor about reducing your dose a little at a time.

Rare Side Effects

Both drugs have the potential for some rare but very serious side effects, including:

  • memory loss
  • abnormal thinking
  • behavior changes
  • worsening depression, suicidal thoughts
  • confusion
  • hallucinations

Some people taking these drugs sleepwalk or do unusual things in their sleep. Some examples are:

  • making phone calls
  • cooking, eating
  • driving
  • engaging in sexual relations

It’s possible to do these things and have no memory of them later. The risk of this side effect is greater if you drink or use other CNS depressants.

To help prevent this, do not take a sleeping pill if you have less than eight full hours in which to sleep. Never mix alcohol and sleeping pills.

Potential Interactions

Before taking these products, tell your doctor and pharmacist about all your medications and supplements. Don’t drink alcohol while using sleeping pills.

Neither sleep aid should be taken with:

  • anti-anxiety medications
  • muscle relaxants
  • narcotic pain relievers
  • allergy medications
  • cough and cold medications that may cause drowsiness
  • sodium oxybate (used to treat muscle weakness and narcolepsy)

Some other drugs that can interact with zolpidem include:

  • antidepressants, including sertraline and fluoxetine; you could have daytime sleepiness when these are combined
  • ketoconazole (an antifungal drug)
  • magnesium sulfate

Do not take zolpidem with these drugs:

  • azelastine
  • rifampin (used to treat tuberculosis)

Eszopiclone also interacts with:

  • magnesium sulfate

Do not take eszopiclone with these drugs:

  • azelastine
  • orphenadrine

Lunesta vs. Ambien: Which Should I Choose?

Both medications are effective, but it’s difficult to know in advance which one will work best for you. Discuss the pros and cons of each with your doctor. Be sure to mention all your existing medical issues. Bring a list of all over-the-counter medications, supplements, and prescriptions drugs you take. Your doctor can help you decide which one to try and in what dose.

If you experience any serious side effects, be sure to report them to your doctor right away. If one medication doesn’t work out, you may be able to take a different one.

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