Key takeaways
Trazodone is an antidepressant that is sometimes prescribed off-label to treat insomnia because of its sedating effects.
Research suggests low doses of trazodone can improve sleep quality, latency, and duration. Still, the American Academy of Sleep Medicine recommends against its use for chronic insomnia due to limited benefits and potential side effects.
Alternatives to trazodone for treating insomnia include FDA-approved medications like Ambien and Lunesta. However, lifestyle changes or cognitive behavioral therapy are recommended before prescription sleep aids.
Trazodone, generic for Desyrel, is a prescription antidepressant that may also help with sleep problems like insomnia. Although not FDA-approved for sleep, healthcare providers sometimes prescribe trazodone off-label because of its sedating effects. Here’s what you should know about using trazodone for sleep.
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Is trazodone approved as a sleep aid?
Trazodone is FDA-approved to treat major depressive disorder in adults, not insomnia. Still, providers sometimes prescribe it off-label to help people sleep, especially those with depression-related insomnia.
Some studies suggest that low doses of trazodone may improve sleep quality and duration. It may also help you fall asleep faster and get more deep sleep. However, the American Academy of Sleep Medicine (AASM) recommends against using trazodone for chronic insomnia, citing limited benefits and potential side effects. A short-term clinical trial showed it was less effective than Ambien (zolpidem tartrate). Instead, AASM recommends FDA-approved sleep aids like Belsomra (suvorexant), Lunesta (eszopiclone), or Sonata (zaleplon).
Related: Trazodone vs. Ambien
What is the typical trazodone dosage for sleep?
The trazodone dosage for insomnia ranges from 25 to 150 mg, although it is typically started at 25 to 50 mg at bedtime. The dosage may be increased gradually, depending on the person’s response to the drug.
“Typically, a starting dose of trazodone as a sleep aid is between 25 to 50 mg at bedtime, but max doses can go higher,” says Dr. Sean Kiesel, DO, who practices family medicine in Nevada. “This is ultimately determined by you and your physician,” he adds. The maximum dose of trazodone for insomnia is 200 mg.
Trazodone is usually only recommended for a short-term treatment of insomnia. People who are on long-term treatment with high doses of trazodone will need to gradually decrease their dosage when discontinuing the drug.
RELATED: Is it safe to take sleep aids every night?
What are the advantages of taking trazodone for sleep?
Though not a first-line treatment for insomnia, trazodone has some upsides:
- Nonaddictive: Trazodone isn’t a controlled substance and is less likely to lead to dependence compared to benzodiazepines.
- Affordable: As a generic medication, trazodone is usually covered by insurance and is cheaper than some brand-name sleeping pills.
- Fast-acting: It starts working relatively quickly, reaching its peak concentration within one to two hours.
- May help sleep apnea: Some studies show it improves breathing during sleep by lowering the apnea/hypopnea index (AHI).
What are the side effects of trazodone?
Common side effects:
- Drowsiness
- Dizziness
- Dry mouth
- Nausea
- Blurred vision
Serious side effects:
- Suicidal thoughts (especially in young people)
- Serotonin syndrome
- Irregular heart rhythms
- Low blood pressure (hypotension) when standing
- Prolonged erection (priapism)
Let your healthcare provider know about all your medications, both prescription and over-the-counter (OTC), as well as your health conditions. Combining trazodone with other drugs that affect serotonin may increase the risk of serotonin syndrome, especially monoamine oxidase (MAO) inhibitors. This can be life-threatening. Trazodone may not be safe during pregnancy or breastfeeding. Always check with a provider first.
RELATED: Is it safe to drink alcohol while taking prescription sleep aids?
Who should (and shouldn’t) consider trazodone for sleep?
Trazodone is generally a safe sleep aid option for those who have a simple health history. It is a good alternative for those at risk of addiction, as some FDA-approved sleep aids can be addictive. It can also help alleviate mild symptoms of depression, which is a bonus for many patients.
Trazodone should be avoided in those who have had certain mental health issues, such as a history of suicidal thoughts, bipolar disorder, cardiac issues, and glaucoma. While it is sometimes combined with other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), caution needs to be taken in order to avoid serotonin syndrome. The one antidepressant drug class it should never be taken with is MAO inhibitors.
Trazodone works on the central nervous system (CNS), so combining it with other medications that work on the CNS can lead to increased sleepiness and adverse effects. This could especially affect older adults. A lower dose of trazodone may be needed. Inform a healthcare professional if a trazodone overdose is suspected.
Are there alternatives to trazodone for sleep?
Trazodone is not typically prescribed as a first-line agent for sleep disorders, as FDA-approved alternatives are available to treat insomnia. The following table shows some examples of different types of prescription sleep aids.
Alternatives to trazodone for sleep |
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|---|---|---|---|
| Drug name | Drug class | Standard dosage | SingleCare savings |
| Ambien (zolpidem tartrate) | Sedative-hypnotic | 5-10 mg | Ambien coupons |
| Silenor (doxepin) | Tricyclic antidepressant (TCA) | 3-6 mg | Silenor coupons |
| Lunesta (eszopiclone) | Sedative-hypnotic | 1-3 mg | Lunesta coupons |
| Unisom (doxylamine succinate) | Antihistamine | 25 mg | Unisom coupons |
| Belsomra (suvorexant) | Orexin receptor antagonist | 10-20 mg | Belsomra coupons |
| Restoril (temazepam) | Benzodiazepine | 7.5-30 mg | Restoril coupons |
| Halcion (triazolam) | Benzodiazepine | 0.125-0.5 mg | Halcion coupons |
| Sonata (zaleplon) | Sedative-hypnotic | 5-20 mg | Zaleplon coupons |
RELATED: Trazodone vs. Ambien
Are there natural or lifestyle alternatives?
In addition to medications, these treatment options may improve sleep:
- Melatonin: A natural sleep hormone available over the counter.
- Benadryl (diphenhydramine): An OTC antihistamine sometimes used for short-term sleep issues.
- Sleep hygiene: Going to bed and waking up at the same time daily; avoiding screens in bed.
- Exercise: Avoiding intense workouts close to bedtime.
- Meditation: Relaxation techniques may ease insomnia.
- Cognitive behavioral therapy (CBT): Often recommended for chronic insomnia.
- Warm milk or tea: May promote relaxation.
- Chinese herbal medicine: Some studies suggest benefits, but more research is needed.
The bottom line: Is trazodone right for you?
The journey to better sleep is deeply personal. Trazodone, with its unique mechanism and generally lower risk of dependence, offers a valuable option for many struggling with insomnia, particularly those whose sleep is disrupted by anxiety. It’s a tool that can provide much-needed relief, but it’s not a magic bullet.
Frequently asked questions about trazodone for sleep
How quickly does trazodone work for sleep?
Trazodone typically reaches its peak effects in about one to two hours, so it starts to work in under an hour for most people.
Is it okay to take trazodone every night?
It may be safe in the short term, but long-term use should be discussed with a provider. Avoid stopping it suddenly because it may cause withdrawal symptoms.
Is Ambien or trazodone better for insomnia?
Ambien is FDA-approved to treat insomnia, and trazodone is not. AASM recommends Ambien over trazodone.
Is trazodone addictive?
No. Trazodone is not a controlled substance and is not considered addictive, though it can be habit-forming.
- Trazodone for insomnia: A systematic review, Innovations in Clinical Neuroscience (2017)
- Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline, Journal of Clinical Sleep Medicine (2017)
- Trazodone hydrochloride tablet, DailyMed (2025)
- Trazodone effects on obstructive sleep apnea and non-REM arousal threshold, Annals of the American Thoracic Society (2015)
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