If you spend your nights tossing and turning instead of peacefully dozing off, you are not alone. One-quarter of adults in the United States have sleep difficulties, according to a report from the CDC (Centers for Disease Control and Prevention). 14.5% of the participants reported that they could not fall asleep every day or most days in the last month.
The good news is that you can address your sleep issues in many ways, including non-pharmaceutical methods like CBT-I (cognitive behavioral therapy for insomnia). Still, such methods might not always work, at least not independently, so medication may be necessary to treat the problem. When it comes to prescription drugs, Ambien and Belsomra are the most popular solutions.
This Belsomra vs. Ambien comparison explains the crucial differences between the two options and presents potential alternatives to these medications.
How Does Belsomra Work?
Image source: Ekaterina Bolovtsova
Belsomra is an FDA-approved medication for treating insomnia, a condition that causes difficulties in falling or staying asleep. The active ingredient in Belsomra is suvorexant, classified as an orexin receptor antagonist. Orexins, neuropeptides produced by brain cells, target specific areas of the brain that cause wakefulness—and Belsomra prevents orexins from finding their targets.
The medication blocks chemical signals in the brain that cause waking up. Even if orexins are released, they shouldn’t interrupt your sleep while you’re on Belsomra.
Belsomra is available in tablet form in the following doses:
- 5 mg
- 10 mg
- 15 mg
- 20 mg
The standard dose is 10 mg, taken orally 30 minutes before bedtime. The maximum intake should not exceed 20 mg per day. Food can delay the onset of effects, so you shouldn’t take Belsomra with or right after a meal.
Who Can Take Belsomra?
Belsomra can be prescribed to adult patients (18+) with insomnia or other sleep difficulties. Persons suffering from specific mental disorders or other health conditions, including depression, glaucoma, renal impairment, severe respiratory problems, narcolepsy, and liver disease, should not take this medication.
According to the U.S. Drug Enforcement Administration’s (DEA) classification, Belsomra has some potential for abuse and dependence, so the drug is categorized as a Schedule IV controlled substance. You can only get this medication if your healthcare provider prescribes it, not over the counter.
Belsomra can interact with other drugs, particularly opioid pain medication, tricyclic antidepressants, and anxiolytics, so you should inform your healthcare provider of any treatments or conditions you might have before taking Belsomra.
Keep in mind that the drug is relatively new, as it was approved by the FDA in 2014, so medical professionals and patients have limited experience with its long-term efficacy or side effects.
"I'm sorry for all that have had bad experiences with Belsomra. I've been taking 15mg for a week. It doesn't work like Ambien. It works differently. You won't feel drowsy. I have to stop what I am doing and lay down. It takes only a few minutes to fall asleep. You MUST take this drug on an empty stomach! It won't work otherwise. I take it two hours after a meal. I've not had any terrible nightmares. Remember for it to work well you have give it enough time, taking on an empty stomach, and it doesn' work the same way as Ambien or a benzo. I gave the drug an "8" because it works well, but not quite as well as Ambien which I was used to taking 20mg! …"
80sCh… , Drugs.com
The Side Effects of Belsomra
Common side effects of Belsomra can include:
- Impaired motor functions
- Cough and upper respiratory tract problems
- Abnormal dreams
Higher doses can increase the chances of side effects, so working with your doctor to find the effective minimum dose is crucial. Belsomra can also cause allergic reactions, so you should stop taking it if you notice skin reactions, swelling, or trouble breathing.
The drug can interact with specific types of food—especially grapefruit—which can increase the medication levels in the blood. You should avoid alcohol when taking Belsomra because the combination can amplify the side effects.
How Does Ambien Work?
Image source: Polina Kovaleva
Ambien has been on the market for over 30 years since the FDA approved it for treating insomnia in 1992. It’s the most famous Z-drug, with over 10 million prescriptions generated every year. Unlike Belsomra, generic Ambien, Zolpidem, has been available since 2007.
Zolpidem is an active ingredient in Ambien, and the drug is classified as a sedative-hypnotic. It induces sleep by slowing down the brain and the central nervous system (CNS) by activating GABA neurotransmitters, which inhibit brain activity by slowing down breathing and heart rate. Ambien increases GABA levels to help you relax and fall asleep quickly.
The extended-release variant, Ambien CR, contains two layers. The first dissolves immediately to help you fall asleep, and the second has a delayed and regular onset to prevent you from waking up.
The drug comes in the following doses:
Ambien dosing is more complex than Belsomra dosing, especially for female patients. Male patients can begin with 10 mg daily, but female patients should start with 5mg because the drug is metabolized slower in women than in men.
Zolpidem is also available under other brand names, including:
- Zolpimist—Manufactured as an oral spray and used to help initiate sleep
- Edluar—Taken sublingually and used to help with sleep onset and maintenance
- Intermezzo—Administered under the tongue and used in the middle of the night when the patient has difficulties going back to sleep
Keep in mind that these formulations are not interchangeable and must be taken as prescribed by your healthcare provider.
Ambien is taken before going to sleep and shouldn’t be administered earlier in the day because the drug can affect alertness and impact the ability to operate motor vehicles. Food can delay the effects, so don’t take it with or immediately after a meal.
Who Can Take Ambien?
Both Ambien and Ambien CR are available to adults seeking insomnia treatment but must be prescribed by a healthcare provider. Like Belsomra, the drug is classified as a Schedule IV controlled substance with some potential for dependence and abuse.
You shouldn’t take this medication if you suffer from the following conditions:
- Liver disease
- Respiratory depression
- Renal dysfunction
- Alcohol intoxication or abuse
- Drug dependence
Ambien interacts with other medications, so you can’t mix it with CYP3A inhibitors, other CNS depressants, anxiolytics, tricyclic antidepressants, and opioid pain medicines.
Inform your healthcare provider about any treatment or condition you may have so that they can decide whether Ambien is the right choice for you. The drug has been available for a long time, and medical professionals have enough experience to properly assess whether Ambien can help in your case.
The Side Effects of Ambien
The following undesired reactions to Ambien may occur:
- Drowsiness or sleepiness
- Dizziness and lightheadedness
- Dry mouth
- Complex sleep behavior (sleep-walking and sleep-driving)
Zolpidem can provoke allergic reactions, so stop taking the drug if you experience respiratory issues or sudden changes in your skin. Don’t take Ambien with alcohol because the combination increases the chances of side effects.
Ambien vs. Belsomra—Hard Facts
Check out the similarities and differences between Belsomra and Ambien in the table below:
Belsomra and Ambien Precautions
Both drugs can cause complex sleep behavior, such as sleep-walking and sleep-driving or abnormal dreams. You should address these issues with your healthcare provider immediately if they occur.
Ambien and Belsomra may impair alertness or motor functions, so they can affect your ability to drive or perform other demanding tasks the following day. Consulting your doctor is also imperative if you experience sudden depressive episodes or suicidal thoughts while on these medications.
As Schedule IV drugs, Ambien and Belsomra can cause withdrawal symptoms in some patients, including insomnia, irritability, and anxiety. Both drugs fall under the FDA’s Category C regarding pregnancy, so the risk of potential undesired reactions to the mother and her fetus can’t be ruled out. Consult your doctor about whether these medications are safe to use in your particular case.
Ambien and Belsomra Alternatives
Insomnia is a complex condition, so treating it successfully requires a personalized approach. Belsomra and Ambien are popular drugs for insomnia, but they’re not the only options. Other medications include Lunesta, Dayvigo, Gabapentin, Quviviq, Hydroxyzine, Trazodone, or Doxepin, but the best option depends on your symptoms and sleep history.
What Do Doctors Normally Prescribe, Belsomra or Ambien?
The FDA guidelines regarding Belsomra and Ambien don’t recommend one drug over the other for treating insomnia. Your healthcare provider can find the most appropriate option depending on your lifestyle, current health status, and medical history. It’s crucial to inform them of any drugs you take or conditions you may have.
Keep in mind that the first-line treatment of insomnia doesn’t include drugs but cognitive behavioral therapy (CBT), so your doctor will probably recommend it before prescribing medication.
If medication is prescribed by your doctor, it’s essential to follow the instructions and take Belsomra or Ambien as recommended, reporting all side effects to your healthcare provider promptly.
Since Belsomra and Ambien are controlled substances with the potential for dependence and misuse, the FDA guidelines state they should be taken under medical supervision for no more than ten consecutive days. If the treatment fails to produce the desired results in that period, your doctor will evaluate the situation and advise on the next steps.
To get the most effective treatment, you should consult doctors specializing in sleeping disorders, as well as other sleep experts. Various factors affect your sleeping pattern, so you must combine meaningful lifestyle changes, mental hygiene practices, and adequate medication to achieve long-term results.
Insomnia can significantly affect your mood, behavior, performance at work, and overall quality of life, so getting the right treatment is essential. Sleep experts can customize the approach to eliminating sleep problems to your specific needs.
With a significant shortage of sleep medicine specialists in the U.S., it might be challenging to get a prompt solution for your sleep problems locally. The quick development of telehealth and specialized services like Kick can assist in battling insomnia quickly and effectively.
Sleep Well, Be Well With Kick
Kick can help you get a good night’s sleep and overcome insomnia with a personalized treatment tailored to your unique medical history. Insomnia may be common, but finding an effective sleep solution is individual, so work with our doctors to rediscover your best night’s rest and wake up energized.
We’ve helped many people overcome sleeplessness, as evidenced in our Trustpilot reviews.
“Easy but thorough process and fast delivery
Great experience getting my prescription - fast and reliable. If you’re on the fence about ordering from Kick Health, just try it!
Jenny Kim, Trustpilot
Sleep-related issues are frustrating and take a toll on your daily routine, so getting help as soon as possible is crucial. Our team is readily available to work with you on decoding what’s keeping you awake and how to get you back to sleep beyond reaching for generic solutions like Ambien and Belsomra.
Skip the long waits for sleep treatments. At Kick, a comprehensive sleep intake only takes 15 minutes and is reviewed within 24 hours, so you can get back to your best night's rest in no time.
Kick’s program is designed by a Stanford sleep specialist, revolutionizing the way we deal with sleep issues. Here’s how to get started:
- Go to our Sleep Visit page
- Enter the required information and fill out the medical form to help us understand your current issues, health status, lifestyle, and medical history
- Choose whether you’d like to get the prescribed medications in your mailbox or pick them up from a local pharmacy
- Provide your shipping address
Our doctors will come up with the most suitable treatment for your condition. In case we need more information, we’ll notify you immediately. You can provide the additional details via the Kick platform. No appointment, video call, or insurance required—pick up your medication the same day or have it shipped free to you.
Your Best Night’s Sleep Designed by Experts
Based on our team’s assessment, you’ll get two trial prescriptions for highly effective medications. Use the first medicine for one week, and move on to the second the following week while keeping a journal of your progress.
Once you finish your trials, you’ll go over your journal with our team to determine whether the treatment is showing results. If it fails to produce the desired outcome, our doctor will prescribe new medications and continue to work with you until you find the perfect solution.
We offer continual support with expert advice on sleep hygiene based on CBT best practices regarding sleep problems. Combining the appropriate medications with effective cognitive-behavioral techniques is crucial to return to a healthy routine quickly.
If our expert team decides we can’t treat your condition properly, we won’t charge for the consultations as part of our Kick Doctor Guarantee policy. Should this happen, visit your primary care physician to explore potential solutions to your problems with sleeping.
Remember to disclose all the necessary info to our team because it’s the only way to prescribe the right medications and design an effective and safe treatment for you.
Belsomra vs. Ambien—Frequently Asked Questions
Check out the most common concerns regarding Ambien and Belsomra.
Is Belsomra More Effective Than Ambien?
Not necessarily—the effectiveness of both medications depends on numerous factors. You should always consult a doctor specializing in sleep for an appropriate treatment.
Is Switching From Ambien to Belsomra Dangerous?
It can be and should not be done without consulting your healthcare provider. Ambien and Belsomra are controlled substances on the federal level and must be used only as prescribed. If either of the two medicines proves ineffective, consult your doctor about switching to another drug.
Can I Take Ambien With Belsomra?
No, these two drugs must not be taken together, and your doctor will not prescribe such treatment. The combination of Ambien and Belsomra does not increase the treatment effectiveness and can be potentially dangerous.
What Is the Cost of Belsomra vs. Ambien?
Belsomra is slightly more affordable than Ambien, but the generic version of zolpidem can be found pretty cheap. The insurance and Medicare coverage for Belsomra varies, while Ambien is typically available in the insurance and Medicare plans only in the generic form.
Featured image source: Kampus Production