Benzodiazepines for Treating Insomnia

A senior woman dealing with insomnia.
A senior woman dealing with insomnia. Tetra Images/Getty Images
In This Article

Benzodiazepines are a class of drugs that work on the central nervous system. While typically used to treat anxiety, panic disorder, and seizures, they have been used in the treatment of insomnia since the 1970s. Long-term use for this sleep disorder is no longer recommended, however, given the drugs' potential to be addictive.

Often more casually referred to "benzos," common drugs in this class include Valium (diazepam), Xanax (alprazolam), Ativan (lorazepam), and Klonopin (clonazepam). Doral (quazepam), Dalmadorm/Dalmane (flurazepam), Halcion (triazolam), ProSom (estazolam), are Restoril (temazepam) are those that are approved for the short-term treatment of insomnia.

How They Work

Benzodiazepines work to reduce anxiety and promote restful sleep by binding to the gamma-aminobutyric acid-A (GABA-A) receptors in the brain.

GABA is a neurotransmitter, a chemical messenger that travels between neurons. When these medications bind to GABA receptors, it calms the nervous system, inducing sedation, relaxing muscles, and helping to alleviate insomnia.

Side Effects

Benzodiazepines cause fatigue, mental fogginess, and altered motor control that can linger on through the morning after they are taken. This can affect driving safety, job performance, and decision-making. It is important to make sure you don't take the medication too late in the evening if you have to drive in the morning.

Other common side effects include dizziness, amnesia, and difficulty thinking or reasoning. Talk to your doctor if these side effects are bothersome as other medication can be used.

Warnings and Precautions

Take the drug you are prescribed exactly as directed. Never increase the dose or frequency without your doctor's OK.

Benzodiazepines should not be taken with alcohol or other sedating drugs. In particular, do not mix benzodiazepines with opioids, which are commonly found in prescription pain medications and cough syrups. Taking benzos with opioids can have serious side effects, including slowed or difficult breathing and even death. 

Taking benzodiazepines on a nightly basis may cause physical or psychological addiction. Long-term daily use of benzos is not recommended.

Suddenly stopping benzodiazepines after a period of daily use can lead to seizures and other physical withdrawals. Discontinuation of a drug should be done under the care of a physician, who will typically develop a plan for you to safely taper off the medication.

Contraindications

Benzodiazepines should not be used for treating insomnia under certain conditions. Pregnant women, for example, should not use this medication unless approved by an obstetrician.

Benzodiazepine medications should be used with caution by people:

  • Who have depression
  • With a history of alcohol, tobacco, or drug abuse
  • Who are elderly
  • With impaired breathing, liver, or kidney function

A Word From Verywell

Difficulty sleeping can have a negative impact on your daily life and mental health. While benzodiazepines can be an effective treatment for occasional insomnia, long-term daily use can cause physical dependence, putting you at risk for severe and possible life-threatening withdrawals upon stopping.

If you are currently taking benzos for sleep, talk to your doctor about safely discontinuing their use and switching to other non-benzodiazepine medications for insomnia that may be safer for long-term use. In addition, cognitive-behavioral therapy has been shown to be effective in the treatment of insomnia.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Matheson E, Hainer BL. Insomnia: pharmacologic therapy. Am Fam Physician. 2017;96(1):29-35

  2. Asnis GM, Thomas M, Henderson MA. Pharmacotherapy treatment options for insomnia: a primer for clinicians. Int J Mol Sci. 2015;17(1). pii: E50. doi:10.3390/ijms17010050

  3. Atkin T, Comai S, Gobbi G. Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery. Pharmacol Rev. 2018;70(2):197-245. doi:10.1124/pr.117.014381

  4. U.S. Food and Drug Administration. FDA drug safety communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. Updated September 20, 2017

  5. Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Ann Intern Med. 2015;163(3):191-204. doi:10.7326/M14-2841