UBCNews - Business - Does Trazodone Work For Insomnia? Possible Side Effects & Better Alternatives

Episode Date: December 16, 2025

Welcome back, everyone. Today we're tackling something that affects millions of people every single night - insomnia. And specifically, we're talking about trazodone. You've probably heard of it, maybe even been prescribed it. But does it actually work for sleep? Mission Connection City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionconnectionhealthcare.com/

Welcome back, everyone. Today we're tackling something that affects millions of people every single night, insomnia. And specifically, we're talking about tracidone. You've probably heard of it, maybe even been prescribed it. But does it actually work for sleep? That's the million dollar question, isn't it? Trazadone is interesting because it's actually an antidepressant that doctors prescribe off-label as a sleep aid. It's not FDA approved for insomnia, but it's been used. used that way for years. Off-label, right? So how common is that practice? Very common. Research shows that off-label prescribing is widespread in the U.S. Trazidone works by altering serotonin

levels in the brain and blocking certain receptors, histamine and alpha adrenergic ones, which promotes relaxation and drowsiness. So it's not designed to put you to sleep, but the side effects kind of do that job? Exactly. And one of the one. big advantage is that it's not considered addictive, like benzodiazepines. That's a huge deal for people who need long-term help with sleep but are worried about dependency. Makes sense. What about dosage? How much are we talking here? Most often, doctors prescribe between 50 to 100 milligrams as a sleep aid. Research indicates that 50 milligrams taken before bed may help you fall asleep quicker, stay asleep longer, and overall improve sleep duration.

Your doctor will determine the right dose for your specific needs. Lower doses also tend to cause less daytime sleepiness. That makes sense. But I imagine there are some downsides, right? What are the side effects people should know about? Oh, definitely. Common ones include drowsiness during the day, nasal congestion, blurry vision, and fatigue.

These tend to show up when you first start taking it. Some people also experience swelling or fainting, though those are less frequent. And what about the more serious risks? This is critical. The FDA issued a black box warning for trazodone because of an increased risk of suicidal thoughts and behaviors, especially in children and young adults.

There's also serotonin syndrome, abnormal heart rhythms, painful erections, that's called priapism, low blood pressure, sodium imbalance, and increased bleeding risk. Wow, that's a pretty serious. list. So for people listening, if you're considering trezodone, you really need to have that

conversation with your doctor. Absolutely. And there's also the risk of overdose, especially if you combine it with alcohol or benzodiazepines. Symptoms can include seizures, vomiting, heart rhythm changes, even respiratory arrest. That point about serious risks and side effects sets up our next piece, safer alternatives. But first, a quick word from our sponsor. If you're struggling with insomnia, depression, or anxiety, finding the right support matters. Mission Connection Healthcare offers licensed mental health care with a focus on holistic treatment beyond weekly therapy. With locations in Virginia, California, and Washington, plus flexible telehealth options, you can find affordable, accessible care that fits your life.

Learn more at missionconnectionhealthcare.com. Picking up on those serious risks and side effects, Are there any situations where tracadone might actually offer unexpected benefits? There's some research suggesting that for people with obstructive sleep apnea, a 100 milligram dose may improve something called respiratory arousal threshold. Basically, you might be less likely to wake up during the night because of breathing interruptions. But I should mention that studies have shown mixed results on this. That's really specific. Are there other benefits that go beyond just sleep?

There are. Trasadone might help improve slow-wave sleep, which researchers believe could slow certain types of age-related mental decline, like dementia in older adults. It's also less expensive than many other insomnia drugs because it's available generically. So it has some unique advantages. But here's what I'm curious about. What do the experts say?

Do they recommend it as a first choice? Not really. The American Academy of Sleep Medicine doesn't recommend Trazodone as a first choice. first-line treatment for insomnia. In other words, it's not their go-to option, even for people with depression or anxiety. Instead, they suggest starting with non-pharmacological methods. Like what? Cognitive behavioral therapy for insomnia, that CBTI, is considered the gold standard. It focuses on restructuring the thoughts, feelings, and behaviors contributing to insomnia. There's also improving sleep hygiene, practicing relaxation methods, and addressing

lifestyle factors. Right. So medications aren't always the first answer. What does CBTI actually involve? It includes techniques like stimulus control, where you only use your bed for sleep and sex, not for watching TV or scrolling your phone. There's also sleep restriction, which limits time in bed to increase your drive to sleep. And relaxation training, breathing exercises, progressive muscle relaxation, meditation. I actually worked with a patient once who couldn't believe how much difference just getting out of bed when she couldn't sleep made. She'd spent years lying there frustrated. I see. That's powerful. That sounds like it takes more effort than just popping a pill, though. It does, but the results are impressive. Many patients with primary insomnia experience

significant improvements with CBTI, and those benefits are often maintained over time, unlike medications which can lose effectiveness. So to everyone listening, if you're dealing with insomnia, what should your first steps be? Have you tried any of these non-medication approaches? Start with the basics. Maintain a consistent sleep schedule, even on weekends. Create a nightly routine that helps you wind down. Don't lie awake in bed if you can't sleep after 10 minutes, get up and do something relaxing, and watch your daytime habits. Exercise helps, but avoid caffeine and alcohol close to bedtime. Those are practical steps anyone can try, but I want to ask,

if someone's already on tracidone and it's working, should they stop? Never stop suddenly. If you're considering stopping trazidone, speak with a doctor about slowly reducing your dosage. Suddenly quitting can cause withdrawal symptoms, known as discontinuation. syndrome because your body has adjusted to the drug. That's really important. I mean, nobody wants to trade one problem for another, right? Exactly.

And honestly, if I had a dollar for every time someone stopped a medication cold turkey without telling their doctor, I could probably retire early. Ha, yeah, that tracks. So the takeaway here is that trezidone may help some people with insomnia, but it comes with real risks and isn't recommended as a first choice by sleep medicine experts. And there are solid alternatives, particularly CBTI, that might offer longer-lasting benefits. Exactly.

The key is having an informed conversation with your health care provider about what's right for your specific situation. Insomnia is complex, and the solution often involves more than just medication. Well said. Thanks for breaking all of this down today. For more information and resources, visit Mission Connection Health Care. Until next time, sleep well, everyone.