Trazodone dosage for sleep: how to take it?

trazodone dosage for sleep
Medically reviewed by Dr. Mehvish Khan

Key Takeaways

  • Trazodone is an antidepressant drug that is frequently used, particularly in the USA, where it is marketed as Oleptro or Desyrel, to treat insomnia. It is generally considered safe for use as a sleep aid in adults, with a history of prescription dating back to the 1980s, although caution is advised for younger individuals due to limited safety data.
  • Adherence to proper usage guidelines is crucial, including following the prescribed dosage, taking the medication with or after meals to reduce side effects, and being cautious about missed doses.
  • A small trazodone dosage (between 25 mg and 100 mg) may help with sleep issues when given 30 minutes before bed. It offers several advantages for sleep, such as its soothing properties, off-label use for insomnia, lower abuse potential compared to some alternatives, potential improvement in sleep architecture, and absence of physical dependence. It can also address both mood symptoms and sleep difficulties for individuals with depression or mood disorders.

Overview

Created in Italy in the 1960s as a depression medication, trazodone has been used since the 1970s to treat major depressive disorder (MDD). It wasn’t authorized to treat MDD in the United States until 1981. In the United States, trazodone is the 25th most prescribed medication as of 2019. Approximately five million people were prescribed trazodone in only one year. Over the past ten years, trazodone has been one of the most often given sleep aids in the United States. According to data from 2022, around 20% of Americans who have insomnia are taking this medication to aid in their sleep. In this article, we will study the safety of trazodone for sleep, proper use, dosing and some advantages.

Is Trazodone safe to take for sleep?

“Unfortunately, a lot of patients do not talk to their doctor about sleep problems until they are really suffering, “ 

say Dr. Jennifer L. Martin is the President of the American Academy of Sleep Medicine (AASM) and holds board certification in behavioral sleep medicine from the American Board of Sleep Medicine (ABSM). Additionally, she serves as a professor of medicine at the David Geffen School of Medicine at UCLA.

Sleeping is essential for maintaining general health and well-being since it promotes mental clarity, emotional stability, and physical well-being. Due to the substantial effects insomnia can have on day-to-day functioning, including decreased focus, elevated stress levels, and a higher likelihood of mental health problems, treating sleep disorders is crucial for maintaining general health.

Adults can safely use Trazodone to sleep. However, there needs to be more information regarding Trazodone’s safety in youngsters; thus, it isn’t advised. Healthcare professionals have been prescribing Trazodone as a sleep aid since the 1980s, even though it is not formally licensed for use in sleep. At modest doses, trazodone may be a safe and effective treatment for insomnia.

Trazadone does, however, still carry some hazards, much like other drugs. Numerous factors, including your age, any other conditions you may have, and any other medicines you are taking, will need to be considered by your provider. If any of the following circumstances or medical problems apply to you, taking trazodone might not be safe for you:

  • Bipolar disorder
  • Glaucoma
  • Heart disease
  • Kidney problems
  • Liver problems
  • Low blood pressure
  • You’re an older adult
  • You’re pregnant or breastfeeding.
Get connected with a healthcare professional now for a consultation and prescription of Trazodone.

How do you take Trazodone for sleep?

When using this drug, strictly follow your doctor’s recommendations. Stay under the recommended dosage, frequency, or course of therapy. The Medication Guide with the medication should be read and followed carefully. Seek clarification from your pharmacist or physician if you have any queries.

Proper Use

To reduce nausea, vertigo, and lightheadedness, take the standard pill with or soon after a light meal or snack. Take the extended-release medication simultaneously each day, preferably before bed and without food if you are using it. As instructed by your doctor, swallow the pill whole or take half of it; do not chew, break, or crush the tablet without first getting your doctor’s permission.

Dosing

Regular dose for insomnia:

The typical dosage of Trazodone for insomnia ranges from trazodone 50 mg to 100 mg at bedtime, with minimum initial doses of 12.5 to 50 mg considered, especially for palliative care patients. Adjustments in dosage, up to a maximum of 200 mg at bedtime, may be made based on individual response and tolerability, particularly in patients with substance use disorder, where Trazodone is preferred due to its low abuse potential.

Insomnia along with depression:

In cases of insomnia associated with depression, trazodone is used as an adjunct to other appropriate antidepressant treatments, such as SSRIs, with a standard dosage range of 50 to 300 mg at bedtime. While higher doses of up to 600 mg/day have been explored, the evidence of increased benefit is uncertain, and it may lead to heightened adverse effects.

Missed Dose

Take the missed dose once you remember. But if your next dose is almost here, skip the one you missed and return to your usual routine. Avoid taking two doses at once.

Get the personalized dosage regimen of trazodone for sleep!

Storage

Store the medicine in a closed box at room temperature, protecting it from heat, moisture, and direct light. Avoid freezing. Keep it out of reach of children. Dispose of any unused or outdated medicine as instructed by your healthcare professional.

Overdose

An overdose of Trazodone can be severe and may require immediate medical attention. Taking too much Trazodone can cause symptoms including:

  • Being sick
  • Feeling very sleepy
  • Being confused
  • Feeling dizzy or fainting
  • Problems with your heart or breathing
  • A fit or seizure

How long does it take to take Trazodone for sleep?

Trazodone’s sedative effect calms the brain and lowers anxiety levels, which improves the quality of sleep. Thus, people can sleep for more extended periods and fall asleep more quickly. After taking their recommended dosage, most people begin to experience the sedative effects of Trazodone for sleep 30 to 60 minutes later. 

What are the advantages of Trazodone for sleep?

Trazodone is sometimes prescribed for sleep despite being primarily an antidepressant, and it does have certain advantages in certain situations. Here are some potential benefits of using trazodone for rest:

Sedative Properties

Trazodone has sedative effects, which can help induce sleepiness. This property makes it useful for individuals who have difficulty falling asleep and struggle with insomnia.

Off-Label Use

While Trazodone is primarily approved for the treatment of depression, its off-label use for sleep is relatively standard. Healthcare providers may consider prescribing trazodone for rest when other sleep medications are unsuitable or ineffective.

Low Abuse Potential

Trazodone is not considered a controlled substance, and it has a lower potential for abuse compared to some other medications used for sleep. This can be an advantage in terms of safety and regulatory considerations.

Improvement in Sleep Architecture

Trazodone may improve sleep architecture, including an increase in slow-wave sleep. This can be beneficial for individuals with certain sleep disorders.

No Risk of Physical Dependence

Unlike some other medications used for sleep, trazodone is not associated with the development of physical dependence. This means that discontinuing the medication does not typically result in withdrawal symptoms.

Anxiety Reduction

Trazodone may have anxiolytic (anxiety-reducing) effects, which can be helpful for individuals who experience anxiety that interferes with sleep.

Dual Purpose

For individuals who also suffer from depression or other mood disorders, trazodone can provide a dual benefit by addressing both mood symptoms and sleep difficulties.

When should I see a doctor?

Here are some specific situations in which you should consider seeking medical advice:

Chronic Insomnia

It is advisable to get advice from a healthcare provider if you cannot fall asleep, stay asleep, or have a peaceful sleep for longer than a few weeks regularly.

Changes in Sleep Patterns

Suppose there are significant changes in your sleep patterns, such as sudden insomnia, excessive daytime sleepiness, or frequent waking at night. In that case, discussing these changes with a doctor is essential.

Sleep Disorders

If you believe you may have a sleep disorder or have been diagnosed with one (like narcolepsy, sleep apnea, or restless legs syndrome), you must get medical attention. These disorders often require specialized attention and interventions.

Worsening Signs of Mental Illness Anxiety and depression are two mental health issues that are occasionally linked to sleep issues. Talking with a mental doctor about any changes in anxiety or increasing mood disorder symptoms is crucial.

Use of Medications

If you are considering using medications, including over-the-counter or prescription sleep aids, it’s recommended to consult with a doctor provider before starting any new medication. They can guide you in the most appropriate and safe options based on your medical history and health.

Concerns About Medication Side Effects

If you are taking medications for sleep or any other condition and are concerned about side effects or interactions, consult your doctor. Do not stop or adjust medications without professional guidance.

  • Common Side Effects:
    • Drowsiness
    • Dizziness
    • Dry mouth
    • Blurred vision
    • Constipation
    • Weight changes
    • Headache
    • Nausea
  • Less Common Side Effects:
    • Fatigue
    • Nervousness
    • Lightheadedness
    • Changes in sexual interest or ability
    • Stomach upset
    • Diarrhea
    • Sweating
  • Serious Side Effects (Seek Medical Attention):
    • Fainting
    • Irregular heartbeat
    • Mental/mood changes (e.g., agitation, aggression, mood swings)
    • Uncontrolled movements or vocal outbursts (tics)
    • Tremor
    • Difficulty urinating
    • Signs of infection (e.g., fever, persistent sore throat)
    • Shortness of breath

This list is not exhaustive, and individuals should promptly report any unusual or severe reactions to their healthcare provider.

Dose and dosage change according to age and weight; get the personalized dose for you by connecting with your doctor now!

Persistent Snoring

Prolonged, loud snoring and breathing pauses may indicate a severe sleep disease called sleep apnea. Seeking evaluation and suitable management is crucial.

FAQs about trazodone dosage for sleep

Who should not take trazodone for sleep?

Specific individuals may not be able to use trazodone safely, particularly those with heart problems, mental health conditions, or who are expecting or nursing a baby. Neither older people nor those under 25 should use it.

Is trazodone addictive for sleep?

There’s no proof that trazodone causes addiction. However, if you stop taking it abruptly, you can experience withdrawal symptoms. This may make it difficult for you to fall asleep, make you agitated, and increase your sweat.

Is trazodone safe for sleep in the elderly?

Because of its exceptional safety and tolerability, as well as its unique anxiolytic and sleep-normalizing effects, trazodone is clinically effective in older patients, especially those with agitated behavior. A very modest initial dose is advised for older people, typically no more than 25–50 mg/day. 

Does trazodone affect your thinking?

Trazodone may impair thinking and attentiveness due to its soothing and sleepy effects. Long-term trazodone usage has also been linked to problems with verbal learning, equilibrium disruption, and short-term memory impairment, according to a Journal of Sleep Research report.

Is trazodone effective and safe for treating insomnia?

Insomnia should not be treated with trazodone. Trazodone reduces the number of awakenings during the night and may enhance subjective sleep quality; however, it has no discernible effect on sleep efficiency, latency, total sleep length, or waking time following sleep initiation.

Will trazodone make me drowsy in the morning?

When Trazodone is used, the body may experience serotonin syndrome, a disruption of the neurological system, or a drop in sodium levels. The most typical adverse reaction consists of drowsiness, which includes waking up feeling foggy.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Mendelson, Wallace B. “A review of the evidence for the efficacy and safety of trazodone in insomnia.” Journal of Clinical Psychiatry 66.4 (2005): 469-476.
  • Jaffer, Karim Yahia, et al. “Trazodone for insomnia: a systematic review.” Innovations in clinical neuroscience 14.7-8 (2017): 24.
  • Montgomery, I., et al. “Trazodone enhances sleep in subjective quality but not in objective duration.” British journal of clinical pharmacology 16.2 (1983): 139-144.
  • Mouret, J., et al. “Effects of trazodone on the sleep of depressed subjects—a polygraphic study.” Psychopharmacology 95 (1988): S37-S43.

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