10 best remedies for insomnia

Review of the best according to the editorial board. On the selection criteria. This material is subjective and does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.

According to the RBC agency, in April 2019, Rosstat's observation was published, which was carried out in September last year in all regions of the Russian Federation through surveys of people over 15 years old. As a result, it turned out that in the past year those people who needed medical assistance went to a medical institution only in 65% of cases, and 34% of those surveyed were self-medicating. When asked why people treat themselves and do not go to doctors, various answers were received, but more than 30% of the respondents (first place) said that they were not satisfied with the work of a medical organization.

Of course, this is a sad statistic. And precisely because people try to self-medicate for a wide variety of health problems, various reviews of drugs that can be purchased without a prescription are very popular. On the one hand, these reviews have an unconditional positive effect, of course, if they are written by professionals. But why not familiarize people not only with prescription drugs, but also with those prescription drugs that are recognized all over the world, and can be indicated for certain disorders? After all, if a person reads, then wouldn't this be a reason to go to the doctor and tell him about his health?

Following this approach, this ranking of sleeping pills will include both prescription drugs, which are prescribed by a doctor, and drugs that are freely available at the pharmacy. All drug prices are for spring 2019.

A bit of history

The history of the development of sleeping pills goes back several millennia. Even in ancient Rome, the calming, relaxing effects of dried rhizomes and roots of medicinal valerian were known. Even senators and noble patricians did not disdain such a means as a sleeping pill stuffed with dried herbs.

In the East, sleepy poppy juice, Papaver Somniferum, and then hashish and opium tincture were first used as a sleeping pill. There is a lot to say about the dangers of such a sleeping pill, and opium addiction was a scourge of people who tried to cope with insomnia.

Finally, from the middle of the 19th century, barbiturates, derivatives of barbituric acid, became known. Until the 70s of the twentieth century, drugs such as luminal, veronal, barbamil were used. But barbiturates had serious flaws. They really showed a hypnotic effect, and along the way helped fight anxiety, but if treated for a long time, they caused serious drug dependence and addiction. After using barbiturates, people lost control over their emotions and behavior, and if the dose is increased, then barbiturates cause serious anesthesia.

By the way, drugs for anesthesia from the group of barbiturates are still used when a short operation is needed. For example, thiopental sodium is such a drug. Currently, barbiturates have been completely replaced from the hypnotic market, and they are very limited in the treatment of some forms of epilepsy, such as phenobarbital. Surprisingly, phenobarbital can be freely purchased in a pharmacy without a prescription, it is included in the well-known and most inexpensive soothing drops – Corvalol, Valocordin and the like. But we will talk about non-prescription drugs below.

Then the barbiturates went out of the way, and benzodiazepines came to replace them. They are still present in the arsenal of modern medicine, just like some antipsychotics.

Watch out for insomnia!

Starting to describe sleeping pills, it should be recalled that insomnia does not always need to be fought with medication. There are dangerous diseases, the symptom of which can be persistent sleep disturbance. Such diseases include:

thyrotoxicosis, or hyperthyroidism. This is an overactive thyroid gland. In addition to insomnia, weight loss, constant low-grade fever, a tendency to diarrhea, a constant feeling of fever, tearfulness, irascibility and irritability are characteristic;

chronic, persistent sleep disorders can be on the background of depression, and in this case it is necessary to begin to deal with it. When a person is brought out of a state of depression, sleep will also be normalized;

Chronic sleep apnea is a serious problem, when, against the background of large body weight, low tone of the muscles of the soft palate, there are periodic attacks of cessation of breathing during sleep. After a while, a rapid awakening follows, and everything starts again. Such patients often suffer from insomnia, but they are strictly forbidden to take many sleeping pills, since they may simply not wake up.

Some forms of Parkinson's disease, some types of strokes, meningitis, forms of acute and chronic encephalitis, dementia can occur with insomnia. Therefore, in any case, before taking more or less serious sleeping pills, it is necessary to consult a doctor. Self-medication with sleeping pills is dangerous and can be fatal.

Rating of the best insomnia remedies

Nomination	a place	Name of product	price
Best Benzodiazepines and Antipsychotics	1	Nitrazepam (Radedorm)	RUB 64
	2	Phenazepam	116 RUB
	3	Teraligen (alimemazine tartrate)	267 r
Z – hypnotics	1	Somnol (zopiclone)	199 RUB
	2	Sanval (zolpidem)	RUB 1,900
	3	Andante (zaleplon)	RUB 250
	4	Attention: Belsomra!	732 RUB
best OTC drugs	1	Melaxen (Melarena, Melarithm, Sonnovan)	RUB 499
	2	Donormil (doxylamine)	117 RUB
	3	Corvalol	RUB 12

The best benzodiazepines and antipsychotics

The drugs from this group are distinguished by their low price, long experience of use in medicine (several decades), accurate knowledge of all contraindications and side effects. Many of these drugs are purchased by hospitals, but many of them require the shortest possible course of action, which is generally typical for sleeping pills. The shorter the course of administration, the greater the effect, and the less chances of developing side effects.

Nitrazepam (Radedorm)

Rating: 4.9

Of the many benzodiazepines, it is nitrazepam that is positioned as a hypnotic, and it is prescribed for sleep disorders. It binds to specific benzodiazepine receptors, and acts on GABAergic synapses, and this causes significant inhibition of the function of the cerebral cortex. Along the way, nitrazepam has an anticonvulsant effect and a muscle relaxant, or muscle relaxant. Nitrazepam is indicated for various sleep disorders, for some forms of seizures, including in infants. Nitrazepam is used as a sleeping pill half an hour before bedtime. Adults are prescribed from half a tablet to 1 tablet, and maximum per day should not be given more than 2 tablets, or 10 mg. Each tablet contains 5 mg. The domestic Moscow endocrine plant produces nitrazepam, and a pack of 20 tablets costs 69 rubles.

Advantages and disadvantages

Nitrazepam works quite quickly and strongly, the duration of sleep increases, as well as depth. Sleep from the superficial becomes calm and deep. But alas, nitrazepam has daytime sleepiness, which is a serious disadvantage, and an even more serious disadvantage is withdrawal syndrome. If you take the drug and stop taking it abruptly, then insomnia occurs. In addition, the drug is contraindicated for persons with chronic alcoholism, drug addiction, pregnant and lactating women. As mentioned above, it can be prescribed to children, and even to infants in case of seizures. Other side effects include stunnedness, slowing down of reactions, and most importantly, a decrease in concentration. Therefore, if you take a nitrazepam tablet in the evening in order to improve your sleep, then it is advisable not to drive in the morning.

Phenazepam

Rating: 4.8

Phenazepam is used more often than nitrazepam. It also belongs to the benzodiazepine class and is widely used in modern medicine. In the same way as nitrazepam, it acts on GABAergic transmission, and at the same time further reduces anxiety, reduces emotional stress and anxiety. Therefore, Phenazepam is indicated not only for sleep disorders, but also for the treatment of panic attacks, anxiety attacks. Phenazepam finds application in the complex therapy of neuroses, with reactive psychoses, with various psychopathies, and even for the prevention of states of fear. In neurology, Phenazepam is used to treat patients with temporal lobe epilepsy, to relieve high muscle tone, for example, after central strokes.

It is necessary to take phenazepam regardless of food intake, and it is available in several forms. These are ordinary tablets, but also lozenges, that is, dispersible. In the latter case, the tablet must be held on the tongue until it is completely dissolved, and then swallowed. You do not need to drink such a pill with a liquid. If the patient has disturbed sleep, then it is quite enough to take one or two tablets half an hour before bedtime. The maximum daily dose is 10 mg. It is strictly forbidden to use Phenazepam more than 4 tablets per day. It is produced by the domestic company Valenta, and a pack of 50 tablets of 20 mg each costs 196 rubles.

Advantages and disadvantages

The advantage of phenazepam is the ability, in addition to improving sleep, to provide great help to patients with a variety of neuroses, panic attacks, psychopathies. But phenazepam is dangerous because it has a small therapeutic breadth. In case of an overdose, drowsiness, confusion, slowing down of the heart, a decrease in blood pressure and even coma appear. Numerous side effects are possible: a decrease in the number of leukocytes in the blood, a drop in concentration and drowsiness, especially in the case of prolonged use, dry mouth, drooling, a drop in body weight. It is strictly forbidden to use phenazepam during pregnancy, and especially in the first trimester, since congenital malformations and fetal defects are possible. It is forbidden to use Phenazepam in children in adolescents under 18 years of age, during breastfeeding, as well as due to severe depression. There is a proven fact that taking phenazepam against the background of severe depressive disorder significantly increases the risk of suicide. That is why it is necessary to visit a specialist, and not to self-medicate.

Teraligen (alimemazine tartrate)

Rating: 4.7

Teraligen is a representative of a completely different group of drugs, antipsychotics. All these are very serious drugs: tisercin, chlorpromazine, haloperidol. They are used in 'big' psychiatry. But Teraligen is so super-light, and a very delicate antipsychotic, and the period of action is very short. Teraligen is available in 5 mg tablets, and in addition to the hypnotic effect, like all antipsychotics, it produces an antihistamine effect, antiemetic and antitussive. But it is not used as a cough remedy, but is used to treat minor mental disorders. It is prescribed for borderline diseases, for conversion disorders and also for the treatment of sleep disorders of various origins.

The drug is used orally, and the peculiarity of taking Teraligen is that it is not used immediately before bedtime, but three times a day, at a dosage of 5 to 10 mg per day. The dose is divided into three doses. Teraligen is also produced by the domestic company Valenta, and a package of 25 tablets of 5 mg each costs an average of 590 rubles, which is quite a lot.

Advantages and disadvantages

The big plus of Teraligen is the fact that it exhibits, in addition to the sleeping pill effect, others. All of them are quite light, but together they work well and gently. The same severe antipsychotic effect that is manifested in other antipsychotics is extremely weak, and therefore it has few side effects, especially if the dose is not exceeded. But if the drug is taken in a higher dose, then there may be drowsiness, lethargy, and especially in the first days of taking. Then the body copes with these side effects. Sometimes there can be nightmares during sleep, but this also does not happen often.

Best Z – hypnotics

Z-hypnotics first hit the market in 1993. There was a special long search for drugs that would bind to benzodiazepine receptors, exhibit the hypnotic effect of benzodiazepines, and would not have other effects. Finally, such drugs have been found. As it turned out, they have a hypnotic effect, but such effects as muscle relaxation, or muscle relaxation, sedative or sedative effect, they have no anti-anxiety effect. It is important that they all have a very short half-life from the blood, they do not accumulate in the body and do not have an accumulating effect. Almost all of them work mainly not for sleep itself, but for falling asleep. Therefore, first of all, they are shown to those patients who cannot sleep. After they entered the market, sales of other benzodiazepines plummeted as a large number of drugs were marketed as sleeping pills.

Somnol (zopiclone)

Rating: 4.9

In fact, Imovan is the original drug from this group. But it is currently difficult to find, and therefore Somnol can be called its analogue. It is produced by the Latvian company Grindeks, and a pack of 20 tablets costs 190 rubles. As mentioned above, this is a purely sleeping pill. It makes no sense to take it in order to 'calm down': it will not help. The half-life is no more than 6 hours. The degree of binding with receptors in Imovan is high, and sleep is induced quickly.

It is indicated for insomnia and difficulty falling asleep. Despite the fact that they act on the initiating phase of sleep, Imovan copes with both early awakening and frequent nighttime awakenings. Before going to bed, you need to take one tablet daily. In the course of treatment of insomnia of various origins, it is used for a month, no longer. As an exception, you can give two tablets at bedtime to those patients who have persistent and severe forms of insomnia. In the elderly, the dose should be halved and given half a tablet.

Advantages and disadvantages

A huge advantage of Zopiclone is the fact that in the morning there is no weakness and drowsiness, the drug does not cause any daytime sleepiness. The second huge plus is that you can be treated, and then abruptly stop. There will be no withdrawal syndrome. The third huge plus is that in the morning you can drive a car and work with machines and mechanisms. The only drawback is that it is undesirable to combine treatment with zopiclone with alcohol. Against the background of alcohol consumption, attacks of amnesia may occur, that is, loss of memory for previous events, or an overdose phenomenon may occur.

Sanval (zolpidem)

Rating: 4.8

This drug is a little apart. It has some differences in the mechanism of action; it binds to special omega receptors. The effect comes as quickly as that of zopiclone, it makes the time to fall asleep shorter, the quality of sleep improves, the overall duration becomes longer, and the nighttime awakenings decrease and their frequency decreases. It is necessary to take Sanval just before going to bed with some liquid. Before taking the drug, the patient must be sure that he can afford to sleep for at least 7-8 hours. The maximum dose is 10 mg, in old age the dose should be halved, and the course of treatment should not be longer than a month.

Advantages and disadvantages

By and large, zolpidem does not have any special differences compared to zopiclone. Still, it is better to recommend zopiclone. Firstly, zolpidem has a higher price, and secondly, it can contribute to the development of nightmares in the patient, and, most importantly, it is necessary to cancel it gradually during treatment, since the cancellation effect in the form of so-called 'rebound insomnia' is possible. That is, if the patient takes it for longer than 2 weeks, then at 3-4 weeks it is advisable to take it in half and in a quarter dose, before completely canceling it. In addition, while taking zolpidem, in the event that the patient jointly takes drugs for depression from the SSRI group, then the side effect of such a joint action can be various paradoxical mental reactions. In addition, there are isolated cases that addiction is formed to the drug, and patients begin to abuse it. But, as a rule, this is associated with high doses.

Andante (zaleplon)

Rating: 4.7

There are two most famous drugs: Sonata and Andante. Truly beautiful, musical names. Zaleplon is also used for various sleep disorders, and you need to take the drug just before a person goes to bed. In this case, after eating, 2 hours should pass. Another pill can be taken if the patient feels that he cannot fall asleep, that is, not as planned, but as an emergency. The recommended dose for sleep disorders is 10 mg, or one tablet. The same dose is the maximum; it is not recommended to repeat the drug intake. Andante is produced by the Hungarian company Gedeon Richter, and one pack of 7 tablets costs, on average, 530 rubles. This is quite expensive considering the small number of tablets.

Advantages and disadvantages

The main advantage of Andante is the power of impact. He can be considered the most powerful of all Z-hypnotics. But strength doesn't mean security. As in the previous case, Andante may experience a withdrawal syndrome, side effects are varied, among them amnesia is most often noted, that is, loss of memories, development of paresthesias, that is, various sensitivity disorders: numbness, tingling in the fingers. Drowsiness also occurs quite often, and if the drug is taken by women of childbearing age, then they often experience a violation of the ovarian-menstrual cycle.

Andante should not be administered to pregnant and lactating women, persons with renal and hepatic insufficiency, as well as under 18 years of age. The official instructions say that the patient's waiter should be warned before starting treatment that there may be a withdrawal syndrome. It is required that the course of treatment be as short as possible, and in no case longer than 2 weeks.As you can see, there are much more restrictions on taking this drug and possible risks than with zopiclone.

Attention: Belsomra!

Rating: 4.6

Indeed, Z-hypnotics are currently the best hypnotics. But a completely new drug has already entered the US market, which has nothing to do with benzodiazepine receptors. This is Belsomra's drug, or Suvorexant (according to INN).

This is a new drug, and the drug was approved by the FDA in 2014. The mechanism of action of Belsomra is unique: it is an antagonist of orexin receptors. Orexin is a specific neuropeptide that is responsible for our active waking state. The drug blocks specific receptors, and the body stops receiving signals to stay awake. The result is sleep. Therefore, Belsomra approaches the problem of sleep from a completely different angle: It does not at all stimulate falling asleep and does not induce sleep, but 'turns off' wakefulness, no matter how unusual it sounds.

It is necessary to take this remedy in a dose of 10 mg at night, half an hour before bedtime, and it is necessary to plan a sleep of at least 7 hours. You can take no more than 20 mg at a time, that is, no more than 2 tablets. In order to more conveniently determine the dosage, Belsomra is available in different versions: it can be 20 mg, 15, 10 and 5. At the moment, Belsomra is the leader in initiating falling asleep. Usually other sleeping pills accelerate falling asleep by 15-30%, and Belsomra by 40% or more. The drug Belsomra is produced by the company Merck Sharp and Dome.

Advantages and disadvantages

Belsomra has a significant number of advantages. It does not inhibit breathing during sleep, and therefore it can be prescribed to patients with snoring and obstructive sleep apnea. The next day after taking it there is no drowsiness and lethargy, as with other drugs, for example, benzodiazepines. Even elderly patients at a large dosage of 20 mg the next day have no effects of morning sleepiness. At the moment, for four years of use, Belsomra has practically no pronounced side effects. Her therapeutic breadth is quite wide, which means that the risk of overdose is minimal.

In healthy patients, it was found that if you take even 100 milligrams at once, that is, five times more than the maximum recommended dose, then no toxic effects were revealed. Belsomra acts on special receptors, and therefore it is neither addictive nor addictive. In addition, Belsomra completely preserves the structure of sleep, which means that both slow and REM sleep alternate as expected, so the patient feels good the next day.

Belsomra can be taken for a long time. So, it turns out that the drug is perfect? Almost yes. The only drawback: in patients with narcolepsy, it is prohibited for use, since their orexin metabolism is altered, and therefore one of the classic symptoms of narcolepsy is daytime severe sleepiness. But narcolepsy is very rare. And here is the main disadvantage for the Russians: the inability to get it. Many expected the appearance of this drug in Russia in early 2017, but so far the appearance of Belsomra in Russian pharmacies has not taken place. On the websites that send 'expensive' and sell drugs, the minimum cost of the drug is declared: a package of 20 mg 30 pieces – 7900 rubles.

The best over-the-counter drugs

Finally, having told about the very best of sleeping pills not only in Russia, but also in the world, let us return to 'our rams', that is, to such funds that can be bought in Russian pharmacies without a prescription. Of course there are a lot of them. All of them are essentially not hypnotics, but they exhibit a hypnotic effect to one degree or another. We will not talk about peony tinctures, Persen Forte, Novopassite – you can read about all these drugs on a large number of sites. Therefore, we will limit ourselves to only three drugs of different classes. The first of them is antihistamine, the second is, roughly speaking, hormonal. And, finally, you should definitely talk about the main, popular and beloved Russian sleeping pill and sedative – Corvalol.

Melaxen (Melarena, Melarithm, Sonnovan)

Rating: 4.9

One of the best over-the-counter sleeping pills in our country is the drug Melaxen, or its analogues, although according to the official classification, it belongs to adaptogens. And this is understandable: if it were considered a sleeping pill in the pharmacopoeia, then it would be sold by prescription. It contains melatonin, which is a sleep hormone. More precisely, its synthetic counterpart. In nature, melatonin is produced by the pineal gland, or pineal gland, and normalizes the rhythms of sleep and wakefulness. Its action is to accelerate falling asleep, it reduces the number of awakenings at night, gives vigor in the morning, and improves the quality of sleep itself. Melaxen is recommended to be taken with a sudden and abrupt change of time zones, for better adaptation. It is known that the associated disturbance of well-being is called jetlag.

It is necessary to take the drug half an hour before bedtime, one tablet once a day. The maximum dose is two tablets. True, unlike Belsomra, Melaxen is not registered with the FDA, and, despite the fact that it is produced by the American company Unipharm, it is clear that its market is in other countries. A pack of 12 tablets costs 638 rubles on average. The cheapest domestic analogue – the drug Sonnovan from the company Kanonpharm Production (Russia, Shchelkovo) will cost 300 rubles for 10 tablets.

Advantages and disadvantages

There is some evidence that Melaxen really helps to fall asleep only on the first or second day of administration, and then the body gets used to it. There is also evidence that it causes various stormy and colorful dreams. The drug produces a weak contraceptive effect, therefore, if a woman wants to become pregnant, then Melaxen should be excluded. During treatment, you need to refrain from driving a vehicle, there may be side effects such as allergies, swelling, headache and nausea. A complete list of contraindications, in addition to hypersensitivity, pregnancy and lactation, includes more than 10 groups of serious diseases: such as autoimmune diseases, diabetes mellitus, allergic reactions, and so on. So, as a result, it turns out that OTC Melaxen has much more contraindications than prescription Imovan.

Donormil (doxylamine)

Rating: 4.8

Donormil is a rather tricky drug. It belongs to antihistamines, and those who have taken 'harsh' antihistamines such as Diphenhydramine, Suprastin or Pipolfen may recall their sedative effect. Then this action was considered a side effect, it was because of him that the search for modern antihistamines, devoid of sedation, began. But here the developers decided to turn the disadvantage into an advantage, and study the side effect of relaxation and drowsiness in a clinical setting. As soon as studies confirmed that the use of Doxylamine accelerates the time to fall asleep, and at the same time the structure of sleep does not change, it was decided to start producing an antihistamine as an OTC sleeping pill. This is a pretty good marketing ploy, and you need to congratulate the manufacturer on it. The Oops company sells Donormil in the form of effervescent tablets, and a pack of 10 pieces costs 150 rubles. Donormil is prescribed 'from case to case', that is, no course treatment is provided. It is used half an hour before bedtime, one tablet or half of it.

Advantages and disadvantages

It is very important that Donormil does not cause daytime sleepiness, it can be canceled at any time, this is understandable. He's not a hypnotic, but an antihistamine and is devoid of side effects, say, benzodiazepines. But, on the other hand, this absence is more than compensated by the presence of its own side effects inherent in all antihistamines. These are dry mouth, urinary retention, blurry vision, and other troubles. In case of an overdose, of course, the phenomenon of daytime sleepiness will develop, wide pupils will appear, the skin of the neck and face will turn red, possibly tachycardia, anxiety and a host of other 'surprises'. Therefore, you should not abuse Donormil, but take it only in the indicated dosages, and, of course, not every night.

Corvalol

Rating: 4.7

In our rating of sleeping pills was the leader in terms of cost, mystery and difficulty of acquiring for Russians. This is Belsomr's newest drug. Its complete antagonist is the cheapest, the most widespread, the most popular, the most popular domestic drug – Corvalol. He is Valokordin, he is Valoserdin and he has very, very many synonyms. It is produced by all and sundry, since its composition is very simple. Hop oil, mint, valerian derivative ethyl bromisovalerianate, and, most importantly, a highlight: phenobarbital. It is he who has a mild hypnotic effect. We will not list them, you can just pick up the text and read about barbiturates. The cost of Corvalol is extremely low: on average, 1 ml costs 1 rubles, since a 25 ml bottle costs 25 rubles. It is known that one milliliter contains 10 drops on average, which means that one drop is worth 10 kopecks.

Corvalol is accepted for any reason. But the official instruction says that it is useful in case of increased heartbeat with increased frequency (with tachycardia), sleep disorders, irritability, and also with arousal with vegetative manifestations. This means that when, against the background of anxiety and agitation, a reddening of the face arose, threw in sweat, and suddenly the hands became cold – in other words, Corvalol is a first aid for a panic attack. The maximum number of drops for an adult is no more than 30, up to 3 times a day. If there is a need, for example, there is severe tachycardia or an attack of panic attack, then you can increase the dose once, for example, up to 50 drops. Children are limited to 15 drops maximum.

Advantages and disadvantages

The disadvantage of Corvalol and its analogs is that it is not hypnotic (and what we want, all OTC drugs cannot belong to hypnotics), but, nevertheless, phenobarbital in a small concentration, plus a successful combination of plant extracts, do their job. It is a mild, functional remedy with few contraindications, including lactation, pregnancy, severe hepatic and renal failure. In addition, Corvalol contains ethyl alcohol. Therefore, it is contraindicated in alcoholism, convulsions, epilepsy, as well as in severe cardiovascular insufficiency. Another drawback may be a familiar smell to everyone, and if it comes from outside the apartment door when you walk along the entrance, then most likely old people live there. After all, Corvalol, alas, is a universal self-medication for the elderly.

And, finally, some companies got the hang of producing analogues of Corvalol without phenobarbital. Released with a very similar name, it smells exactly the same, and the effect is practically absent. Therefore, before you buy such an ersatz, carefully read the composition of the drug!

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Attention! This rating is subjective and does not constitute an advertisement and does not serve as a purchase guide. Before buying, you need to consult with a specialist.