Trazodone For Sleep and Insomnia

by on May 25, 2012

Discovered and developed in the 1960’s, trazodone was originally approved by the Food and Drug Administration (FDA) for treatment of depression. However, healthcare providers can legally prescribe this medication for any medical condition not indicated by the FDA.  It is frequently prescribed for the treatment of sleep disorders and insomnia.

Trazodone has a sedative effect, which means that it can cause drowsiness. Clinical studies show that about 40.8 percent of patients taking this medication experience drowsiness, making it one of the most common side effects of trazodone. While most people find this side effect bothersome, for others, drowsiness can sometimes be beneficial. Trazodone is especially effective as a sleep-aid for people with insomnia and sleep disorders due to depression. Conversely, some antidepressant drugs can cause sleep deprivation, trazodone can be used to treat insomnia caused by other antidepressants. It may also be prescribed as a sleep aid even for people without depression.

How Trazodone Causes Sleep?

The exact mechanism of action of trazodone is still unclear; however, medical experts believe that it acts on the brain by preventing the uptake of serotonin by receiving nerve cells resulting in increased serotonin levels.

Serotonin is a chemical messenger or neurotransmitter which is responsible for relaying messages from one brain cell to another. Since trazodone interferes with the action of the receiving nerve cells, it results in mostly sedative or hypnotic effects. This side effect of trazodone makes it an ideal sleep drug.

What Studies Say?

Despite the limited studies conducted on trazodone’s effectiveness as a sleep aid in patients without depression, many healthcare providers are convinced that it is an effective sleep drug, based mainly on their clinical practice.

Polysomnographic studies conducted on patients with varying degrees of insomnia suggest that trazodone increases slow-wave (stage 3 and 4) sleep, or often referred to as deep sleep. The American Academy of Sleep Medicine recommends trazodone for insomnia only when there are no other alternatives or other sleep medicines have failed.

One of the studies suggests that trazodone is not capable of sustaining efficacy when used for the management of chronic insomnia. The study showed that after the second week, patients were not equally responsive to the medication as with the first week. This means that frequent increases in dosage are necessary to achieve the desired effect or level of sedation. Therefore, trazodone may not be safe to use in patients with chronic insomnia.

How to Use Trazodone for Sleep Disorders?

When used as a sleep-aid or for insomnia, the recommended starting dose of trazodone is 25 to 50 mg taken at bedtime. The dose may be adjusted if necessary to a maximum dose of 100 mg. Its sedative effect starts within 1 to 2 hours and can last up to 8 hours.

Important notes:

  • Do not take this drug if you cannot go to bed within the narrow “window” of sedative effect. Take trazodone within 60-90 minutes before going to bed. If you miss the onset of hypnotic effect, you may feel very sleepy but have difficulty falling asleep.
  • Take trazodone with food for better absorption.
  • Trazodone may cause grogginess or tiredness on the next morning.
  • Do not attempt to drive or operate heavy equipment upon awakening or after taking trazodone, unless you have learned its effects on you.


Although trazodone is not indicated for insomnia, it is commonly prescribed as sleep aid. Many healthcare providers find it effective and it is relatively more affordable than other sleeping pills. Furthermore, unlike other sleep drugs, trazodone is not habit forming or addictive.

However, since trazodone is associated with other possible risks, it is recommended that patients consult their healthcare provider before taking this drug.