Insomnia · Medication
Sleeping pills:
useful, but rarely the whole answer.
Medication can bring fast relief, but guidelines treat it as an add-on to CBT-I and mostly for the short term. A newer drug class, the orexin receptor antagonists, reached China in 2025. This page sets out what is recommended, what isn't, and why.
Quick answer
Are sleeping pills safe for long-term insomnia?
Guidelines recommend CBT-I first and medication only when CBT-I is not enough or not available. The European Insomnia Guideline (2023) supports benzodiazepines, Z-drugs and low-dose sedating antidepressants for short-term use (up to about 4 weeks). Orexin receptor antagonists such as daridorexant can be used for up to 3 months, or longer in some cases. It advises against antihistamines, antipsychotics, fast-release melatonin, ramelteon and herbal remedies for chronic insomnia. Never stop a sleeping pill abruptly without medical advice.
≤4 weeks
Typical hypnotic course
Benzodiazepines, Z-drugs (European guideline)
Riemann et al., J Sleep Res 2023
≤3 months+
Orexin antagonists
Up to 3 months, longer in some cases
Riemann et al., J Sleep Res 2023
27 May 2025
Lemborexant approved in China
Launched Aug 2025 — first orexin antagonist on the Chinese market
Eisai
June 2025
Daridorexant approved in China
Adult insomnia, onset and/or maintenance
Idorsia
Weak
All AASM drug recommendations
Every drug suggestion in the 2017 guideline is weak
Sateia et al., JCSM 2017
Not advised
Melatonin for chronic insomnia
AASM 2017; fast-release melatonin not recommended in Europe
AASM 2017; Europe 2023
Drug classes
What each class does.
Orexin receptor antagonists
Daridorexant, lemborexant, suvorexant. Block wake-promoting orexin signalling instead of sedating the brain broadly. Europe allows use up to 3 months or longer. Daridorexant and lemborexant are approved in China.
Onset & maintenance
Z-drugs
Zolpidem, zopiclone/eszopiclone, zaleplon. Effective for falling asleep; risks include next-day impairment and complex sleep behaviours such as sleepwalking.
≤4 weeks (Europe)
Benzodiazepines
Temazepam, triazolam and others. Effective, but tolerance, dependence and falls (especially in older adults) limit them to short courses.
≤4 weeks (Europe)
Low-dose sedating antidepressants
Low-dose doxepin is suggested by the AASM for staying asleep. Europe supports low-dose sedating antidepressants short term (grade B). The AASM suggests against trazodone for insomnia.
Maintenance
Not recommended
Antihistamines (e.g. diphenhydramine), antipsychotics, fast-release melatonin, valerian and other herbal remedies. Evidence of benefit is insufficient, and some carry real risks.
AASM 2017 / Europe 2023
Taking sleeping pills now?
Send the name, dose and how long you've taken it. A sleep physician can review it, and plan a taper or switch with your home prescriber.
Guideline detail
AASM and European positions, drug by drug
The AASM 2017 guideline split its weak suggestions by sleep problem: some drugs for falling asleep, others for staying asleep. The European 2023 guideline grades by drug class and caps the duration of use. Both agree that medication works best alongside CBT-I.
| Drug | AASM 2017 | European 2023 |
|---|---|---|
| Zolpidem, eszopiclone | Suggested for onset and maintenance (weak) | BZRAs: short term, ≤4 weeks (A) |
| Zaleplon, triazolam, ramelteon | Suggested for onset (weak) | Ramelteon not recommended |
| Temazepam | Suggested for onset and maintenance (weak) | Benzodiazepines: short term (A) |
| Suvorexant / daridorexant | Suvorexant suggested for maintenance (weak) | Daridorexant (A); orexin antagonists up to 3 months or longer |
| Low-dose doxepin | Suggested for maintenance (weak) | Low-dose sedating antidepressants short term (B) |
| Trazodone | Suggested against | — |
| Melatonin | Suggested against | Fast-release not recommended; prolonged-release up to 3 months if ≥55 (B) |
| Diphenhydramine, valerian, tryptophan | Suggested against | Antihistamines and herbal remedies not recommended |
A = strong grade, B = moderate grade (European guideline). Lemborexant was approved after both guidelines were written. Availability differs by country.
Curious about the new orexin drugs?
Lemborexant and daridorexant are now approved in China. Ask whether either could suit you, and how to combine it with CBT-I.
In China
What changed in 2025
Eisai received Chinese approval for lemborexant (Dayvigo) on 27 May 2025 and launched it on 18 August 2025, describing it as the first orexin antagonist launched in China. Idorsia announced NMPA approval of daridorexant (Quviviq) in June 2025, without psychotropic-drug control labelling. The 2025 Chinese insomnia guideline also discourages long-term hypnotic use.
If you take a sleeping pill now, bring the exact name, dose and how long you've taken it. Tapering, or switching drug class, should be planned with a prescriber. We don't recommend changing medication during a short trip without follow-up at home.
Sleep centres
Where medication
is reviewed.
Shanghai Mental Health Center 上海市精神卫生中心
Sleep-disorder clinic and ward; insomnia with anxiety or depression
Huashan Hospital, Fudan University 复旦大学附属华山医院
Neurology sleep centre with polysomnography
West China Hospital, Sichuan University 四川大学华西医院
Sleep Medicine Center
FAQ
Sleep medications — answered.
- What is the safest sleeping pill?
- No sleeping pill is right for everyone. Guidelines suggest choosing by whether the problem is falling asleep or staying asleep, by age and other conditions, and for the shortest effective time. In Europe, orexin receptor antagonists can be used longer than benzodiazepines or Z-drugs. A doctor should weigh your other medicines and risks such as falls or sleep apnoea.
- Is melatonin a good sleeping pill?
- Not for chronic insomnia. The AASM suggests against it, and Europe does not recommend fast-release melatonin. Prolonged-release melatonin is an option for up to 3 months in people aged 55 and over. Melatonin is genuinely useful for jet lag.
- Are daridorexant and lemborexant available in China?
- Yes. Lemborexant was approved in China on 27 May 2025 and launched in August 2025. Daridorexant received NMPA approval in June 2025. Both need a prescription. Ask your coordinator to confirm the hospital pharmacy stocks them before you travel.
- Can I stop my sleeping pill on holiday?
- Don't stop abruptly, especially benzodiazepines or Z-drugs taken for weeks or longer; rebound insomnia and withdrawal can occur. Tapering is planned with your prescriber, often alongside CBT-I.
- Are over-the-counter sleep aids okay?
- Most contain sedating antihistamines such as diphenhydramine, which the AASM suggests against for chronic insomnia. They can cause next-day grogginess and, in older adults, confusion.
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References
- Sateia MJ, Buysse DJ, Krystal AD, et al. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an AASM clinical practice guideline. J Clin Sleep Med. 2017;13(2):307–349.
- Riemann D, Espie CA, Altena E, et al. The European Insomnia Guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res. 2023;32(6):e14035.
- Qaseem A, Kansagara D, Forciea MA, et al. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–133.
- Chinese Sleep Research Society. 失眠症诊断和治疗指南(2025版) [Guidelines for the diagnosis and treatment of insomnia disorder, 2025 edition]. Zhonghua Yi Xue Za Zhi. 2025;105(34):2960–2981.
- Yan P, Feng S, Ma M, et al. Front Psychiatry. 2025;16:1688561 — summarises the 2025 Chinese guideline: CBT-I offered first-line; hypnotics not recommended long term.
- Eisai. DAYVIGO (lemborexant) approved in China on 27 May 2025 and launched 18 August 2025 as the first orexin receptor antagonist launched in China (company press releases).
- Idorsia. QUVIVIQ (daridorexant) receives NMPA approval in China for adult insomnia (media release, 23 June 2025).
On sleeping pills
and want a plan?
Send your current medication, dose and how long you've taken it, plus a sleep diary. A sleep physician will suggest a plan, whether that means adjusting medication, starting CBT-I or both, coordinated with your home doctor.
This page is for general education only and is not medical advice. Insomnia can be a symptom of other conditions — sleep apnoea, depression, anxiety, pain, thyroid disease or medication side effects — that need their own treatment. Do not stop or change sleeping medication without talking to your doctor. Seek urgent help if you have thoughts of self-harm, or if sleepiness affects your driving.
Published 5 October 2026 · Figures checked against the cited sources by the PandaTouring Care editorial team · Editorial policy