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Medically reviewed by Violetta Shamilova, PharmD
Key Takeaways
- Poor sleep can not only make you feel lousy, but it can also lead to chronic conditions. Implementing healthy habits and relaxation techniques may help you sleep better.
- If you feel trazodone is not helping you sleep, it’s time to talk to your healthcare provider. They can make sure other medications, chronic conditions, or improper dosages are not to blame.
Trazodone is often prescribed for insomnia, but its effectiveness can vary. If it's not helping you sleep, understanding the reasons why can guide you toward better solutions.
1. Incorrect Dosage
If trazodone isn't helping your insomnia, the dosage might be too low. Insomnia doses typically start at 25 to 50 mg at bedtime. Your healthcare provider can adjust the dose if needed. Common doses range from 50 to 100 mg, and up to 300 mg for those with both insomnia and depression. Talk to your healthcare provider about any dosage concerns.
2. Underlying Medical Conditions
If you're still having trouble sleeping while taking trazodone, a chronic condition might be the cause. Conditions that may contribute to insomnia include:
- Acid reflux
- Asthma
- Chronic pain
- Menopause
- Restless leg syndrome
- Sleep apnea
- Stroke
- Thyroid disorder
3. When and How You Take It
Trazodone should be taken before bedtime as it causes drowsiness. Take it 30 to 60 minutes before you plan to sleep, as this is how long it usually takes to start working. Trazodone can be taken with or without food. While taking it on an empty stomach may speed up its effect, it might also cause side effects. If you find taking it on an empty stomach uncomfortable, you can take it with a light meal or snack, which may delay its onset but extend its effects.
4. Stress or Anxiety
Stress and anxiety can impact your sleep. In the United States, about 18% of people will have an anxiety disorder at any given year. Between 70% and 80% of people with anxiety report issues with sleeping.
Getting proper sleep helps to regulate emotions. Lack of sleep can lead to worsening mood and worsening symptoms of anxiety. If anxiety is preventing you from getting adequate sleep, it is essential to talk to your healthcare provider about other options.
5. Drug Interactions
Trazodone interacts with many other medications. Some medications may make trazodone less effective. Your healthcare provider may increase your dosage to make it more effective or change your medication. Medications that may decrease the effect of trazodone include:
- Carbamazepine
- Phenytoin
- Rifampin
- St John’s Wort
6. Side Effect of Other Medications
A side effect of some medications can be insomnia. The following medications and substances can contribute to insomnia:
- ADHD medications
- Alcohol
- Antidepressants
- Appetite suppressants
- Asthma medications, including albuterol and theophylline
- Beta-blockers
- Caffeine
- Corticosteroids
- Diuretics
- Nicotine
- Over-the-counter decongestants and cold medicine
How Trazodone Works for Insomnia
Trazodone is a serotonin antagonist and reuptake inhibitor. It helps with insomnia by acting on neurotransmitters in the brain, specifically the histamine, alpha-1 adrenergic, and serotonin receptors.
Histamine helps to regulate our sleep-wake cycle. Trazodone blocks the H1 histamine receptor and causes drowsiness. Cortisol levels are elevated when stressed, and can affect sleep. Trazodone reduces cortisol levels by blocking alpha-1 adrenergic receptors.
Trazodone also affects the levels of serotonin in the brain. Serotonin is a chemical that regulates sleep, mood, hunger, and body temperature. Serotonin is also necessary to make melatonin, which regulates the sleep-wake cycle.
How Long Does It Take for Trazodone to Work for Sleep?
Trazodone should help you sleep better soon after taking it. It should make you drowsy within 30 to 60 minutes. If you take trazodone on an empty stomach, it will work faster. Food will delay the time it takes to work.
What to Do If Trazodone Isn’t Working
Trazodone might not be effective for everyone. Ensure you maintain a routine that promotes good sleep habits and take trazodone as directed. If it still doesn't help, consult your healthcare provider for alternative options.
Talking to Your Healthcare Provider
If you are still having trouble falling asleep, staying asleep, or feel tired throughout the day, it may be time to talk to your provider.
They may need to run additional tests to check for underlying health conditions, or they may need to change your dosage. Mention all medications you take, and be sure to mention any bothersome side effects you have. Common side effects include:
- Blurred vision
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
- Headache
- Nausea
- Nervousness
- Vomiting
Alternative Medications and Therapies
Research, although limited, has shown that supplements and relaxation therapies may help improve sleep and reduce insomnia. Be sure to choose a high-quality supplement, as they are regulated differently from prescription medications.
Talk with your healthcare provider before adding any supplements to your routine. Your provider will make sure it is safe and appropriate for you to take. Supplements and complementary therapies that may help you sleep better include:
- Acupuncture
- Chamomile
- Cognitive behavior therapy
- L-theanine
- L-tryptophan
- Magnesium
- Melatonin
- Tart cherry
- Tai Chi
- Valerian Root
- Yoga
- Zinc
Lifestyle Tips for Improving Sleep
Not getting enough sleep can not only leave you feeling tired, but it can also lead to chronic conditions. The following healthy habits can help ensure you get a better night's sleep:
- Allow enough time to get proper sleep, ideally 7 to 8 hours
- Avoid alcohol before bed
- Avoid electronic devices an hour before bed
- Avoid large meals within a few hours before bed
- Avoid nicotine use in the evening
- Exercise daily for at least 20 minutes
- Get 30 minutes of sunlight exposure every day, preferably in the morning
- Invest in a supportive mattress and pillow
- Limit caffeine after 2 pm
- Limit naps to 20 minutes
- Minimize noise
- Reduce light by using blackout shades and eye masks
- Set the thermostat between 65 and 68 degrees Fahrenheit
- Wake up at the same time every day
Read the original article on Verywell Health
