Insomnia, restless legs syndrome, narcolepsy, and sleep apnea are all common sleep disorders that can affect your daily functioning and overall well‑being. If sleep issues are left untreated, they may also increase the risk of additional cardiovascular, metabolic, hormonal, and mental health conditions. 

Understanding what may be causing sleep issues 

During the early stages of any sleep concern, it is important to explore why your sleep patterns have changed. Sleep issues can occur due to: 

• physical symptoms such as heartburn or headaches 

• mental health conditions such as anxiety 

• medication side effects 

• stress 

• environmental factors such as light, noise, or temperature 

• behavioural habits such as late exercise or consuming too much caffeine 

Getting an accurate diagnosis is an essential part of developing an effective treatment plan. Understanding the cause helps ensure you have the right supports in place. 

Start with behavioural strategies 

If you are experiencing sleep issues, the best place to start is by improving your sleep hygiene. This includes developing healthy sleep and wind‑down routines and avoiding potential triggers when possible. 

Cognitive behavioural therapy for insomnia has strong research support. It can help you build long‑term skills to manage sleep difficulties and prevent future recurrences. 

Over‑the‑counter and natural products 

If sleep issues continue after trying behavioural strategies, you may consider over‑the‑counter or natural products. However, these options have limitations: 

• Diphenhydramine‑based products (for example, Sleep‑eze, Nytol, Benadryl, Gravol) may cause drowsiness but provide limited benefit and should only be used for very short periods–two to three days maximum. 

• Herbal products such as valerian root do not have reliable evidence showing meaningful improvement in sleep quality. 

• Melatonin may provide small benefits. Research shows that melatonin may shorten the time it takes to fall asleep by 4 to 12 minutes and add about 18 minutes of total sleep time. It may also help with shift‑work sleep challenges or jetlag. 

If you choose to try melatonin, select a product with a Natural Product Number to ensure it meets the quality requirements set by Health Canada. Typical dosing ranges from 1 to 5 mg, taken two hours before bedtime. 

Always speak with your pharmacist or health care provider before starting any new product. 

Prescription sleep medications 

If behavioural strategies and over‑the‑counter products are not effective, your doctor may consider prescription medications. The type of medication depends on the underlying cause of your sleep issues. 

The “Z” drugs 

These include: 

• Imovane (zopiclone) 

• Lunesta (eszopiclone) 

• Sublinox (zolpidem) 

These medications are officially approved for insomnia in Canada and must be prescribed by a physician. Clinical trials show they may shorten the time to fall asleep by about 15 to 20 minutes and add about 30 minutes of total sleep. 

Newer sleep medications 

These include: 

• Dayvigo (lemborexant) 

• Quiviviq (daridorexant) 

They offer similar benefits to the “Z” drugs but may have a better safety profile, including fewer next‑day symptoms. 

Benzodiazepines 

Benzodiazepines are primarily used to treat anxiety but may be prescribed short‑term for sleep because of their sedative effects. Long‑term use can lead to dependency, addiction, and safety concerns, particularly for older adults, individuals with a substance use history, or those taking narcotics. 

Sedating antidepressants and antipsychotics 

These medications are not recommended for insomnia alone. They are usually used when treating another mental health condition that is contributing to sleep difficulties. 

Important considerations 

Most sleep medications are intended for short‑term use, usually one to four weeks, while the underlying causes are addressed. Some individuals may use them longer, but long‑term use often leads to dependency and limited benefit. 

Bottom line 

Insomnia is a common sleep disorder. Treatment usually involves combining behavioural strategies with medication only when needed. It is important to have realistic expectations, as sleep medications offer modest benefits and should be used carefully and for short periods. 

The information provided in this article is for personal use, reference, and education only. ASEBP does not provide medical advice. Before starting any medication or product, you should always consult with your pharmacist, health care provider, or call Alberta Health Link at 811.