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Tramadol vs. Trazodone—Are They Good for Sleep Issues?

Tramadol vs. Trazodone—Are They Good for Sleep Issues?

Sleep is a vital part of our lives, with adults needing about 7–9 hours of sleep each night, according to the National Sleep Foundation. For approximately 30–40% of adults in the U.S. struggling with sleeplessness, this is easier said than done. 

Medications like tramadol and trazodone can provide relief, especially when combined with healthy sleep hygiene. But before using any of these drugs, you should learn about their safety and effectiveness for your sleep issues. Find out more about these drugs, including how they work, what potential side effects they entail, and who can use them in this tramadol vs. trazodone comparison.

What Is Tramadol?

Tramadol is an FDA-approved medication for treating moderate to severe pain. The active ingredient in tramadol is tramadol hydrochloride, which is classified as a synthetic opioid—it’s made in the lab but works the same way as natural opioids.

The drug is classified as a controlled substance by the U.S. Drug Enforcement Administration (DEA). Regular use of this medication raises the risk of addiction, physical dependence, and withdrawal symptoms, and you can only get tramadol with your doctor’s prescription. You can refill your prescription up to five times within six months from the time your healthcare provider wrote it. If you need a refill after that, you must get another prescription.

The typical treatment duration varies based on your health history and response to the medication. You should inform your doctor if symptoms persist even after discontinuing this drug.

How Does Tramadol Work?

Tramadol changes how your brain senses pain. The drug binds to mu-opioid receptors in the central nervous system, reducing your pain perception.

While it alleviates pain, the drug also induces mild lightheadedness and drowsiness, which can make you sleepy. According to clinical studies, tramadol increased the duration of stage 2 sleep compared to the placebo, so the drug may be a viable option when treating short-term sleep problems.

However, tramadol can only help with sleep issues if you use it in small doses and under the guidance of your healthcare provider. Misuse or abuse can counteract this effect, resulting in reduced sleep.

What Are the Side Effects of Tramadol?

Tramadol carries the risk of side effects, including:

  • Dizziness or vertigo
  • Nausea or vomiting
  • Constipation
  • Headache
  • Itching
  • Dry mouth
  • Abdominal pain

Most of these effects are mild and may subside as your body adjusts to the medication. 

More concerning undesirable reactions include:

  • Sweating
  • Trembling 
  • Weak pulse in the legs
  • Yellow eyes or skin
  • Rashes

You should contact your doctor immediately if you experience severe or persistent undesirable reactions.

How Is Tramadol for Sleep Dosed?

Tramadol is available in six doses:

  1. 5 mg
  2. 50 mg
  3. 100 mg
  4. 150 mg
  5. 200 mg
  6. 300 mg

The dosage for sleep varies among patients. If you have sleep problems due to chronic pain, your doctor may prescribe 100 mg, taken once per day. For sleep issues due to moderate or severe pain, healthcare providers typically prescribe 25 mg, taken once per day.

You should take tramadol exactly as prescribed by your doctor. Healthcare providers generally recommend taking the drug at least one hour before bed to allow it to kick in on time.

Still, you should only take tramadol if you can dedicate seven hours to sleep. The effects last about six hours, providing ample time for rejuvenating rest.

Source: Kampus Production

What Is Trazodone?

Trazodone is an antidepressant used to treat major depressive disorder and anxiety. Its active substance is trazodone hydrochloride, classified as a serotonin antagonist and reuptake inhibitor.

Trazodone isn’t listed as a controlled substance since it carries a low risk of physical addiction when taken as prescribed. Still, psychological dependence and potential withdrawal symptoms can’t be disregarded. Like tramadol, trazodone is a prescription-only drug, and you should use it under the continuous guidance of your doctor to reduce the risk of unwanted effects. 

Various clinical studies show that trazodone reduces the period it takes to fall asleep and improves sleep quality. Sleep medicine specialists typically prescribe it off-label for patients with short-term insomnia.

How Does Trazodone Work?

Trazodone works by preventing the reuptake of serotonin by the nerves in the brain. Serotonin is a neurotransmitter that plays several roles in the body, including regulating mood, memory, and sexual behavior.

At the optimum level in the brain, this neurotransmitter promotes a sense of well-being, making trazodone a viable option in treating depression. The drug’s action increases serotonin levels in the nerve synapse, providing a conducive environment for the production of melatonin—a hormone that regulates your sleep-wake cycle. The increased melatonin levels in the body promote calmness and sleep.

What Are the Side Effects of Trazodone?

Trazodone carries the risk of unwanted reactions, but patients who use it under medical supervision rarely experience them. The common ones are:

  • Blurred vision
  • Lightheadedness
  • Dizziness
  • Constipation
  • Unpleasant aftertaste
  • Dry mouth
  • Drowsiness
  • Headache

Rare but concerning side effects may include:

  • Skin rash
  • Swelling
  • Irregular heartbeat
  • Breathing problems
  • Muscle tremors
  • Poor motor coordination
  • Unusual excitement

These lists aren’t exhaustive. You should inform your healthcare provider if you experience any physical or behavioral changes while on trazodone.

How Is Trazodone for Sleep Dosed?

Trazodone is available in six doses:

  1. 10 mg
  2. 20 mg
  3. 50 mg
  4. 100 mg
  5. 150 mg
  6. 300 mg

The average starting dose for patients with sleep problems is 25 mg per day in tablet form. If you have severe insomnia occasioned by depression, your doctor may recommend up to 100 mg daily. Whatever your dose may be, trazodone should be taken at least an hour before bedtime.

These are general guidelines—your doctor will prescribe the appropriate dose for you based on your medical history and specific sleep issues.

Source: Kampus Production

Trazodone vs. Tramadol—Basic Facts

Check out the key similarities and differences between tramadol and trazodone in the table below:




Primarily indicated for

Moderate or severe pain

Major depressive disorder

Used for sleep issues

Yes (off-label)

Yes (off-label)

Active component

Tramadol hydrochloride

Trazodone hydrochloride

FDA approval date



Controlled substance




Tablet, capsule, liquid, suspension

Tablet, capsule, liquid

Available doses

  1. 5 mg

  2. 50 mg

  3. 100 mg

  4. 150 mg

  5. 200 mg

  6. 300 mg

  1. 10 mg

  2. 20 mg

  3. 50 mg

  4. 100 mg

  5. 150 mg

  6. 300 mg

Average starting dose

25 mg per day

25 mg per day

Suitable for children



Pregnancy category

C (risks can’t be disregarded)

C (risks can’t be disregarded)

Treatment duration



Prescription or OTC



Trazodone vs. Tramadol for Sleep—Which Is More Effective?

Both tramadol and trazodone can be effective for sleep, but the results may vary based on your health history and the specific issues contributing to your sleep problems. For example, tramadol may be more effective if you’re experiencing sleeplessness due to severe pain, while trazodone may be the better choice if your insomnia is caused by depression, anxiety, or mood disorders.

Whichever medication works better for you, several complex factors can contribute to sleeplessness, so drugs alone may not offer a comprehensive solution. To get lasting results, you should consult a sleep medicine specialist—but this process isn’t as simple as it seems. 

In the U.S., only about 1% of physicians specialize in sleep medicine whereas approximately 50–70 million adults have some form of sleep problems, so most experts have packed schedules. The good news is that with the emergence of telemedicine platforms, sleep medicine specialists are only a few clicks away. With Kick—an online performance medicine clinic—you can access expert help almost instantly.

Kick—Healthy Sleep, Healthy You

Source: Pavel Danilyuk

Kick’s sleep program lets you consult sleep specialists in only 15 minutes. Once you provide your medical information, our team will design custom treatment and prescribe two trial medications you’ll rotate within the first two weeks to reduce the risk of dependence and get the best results quickly.

Your medications will be delivered to your doorstep or a local pharmacy in a few days, helping you start treatment immediately. Our medications include:

  1. Trazodone
  2. Cyclobenzaprine
  3. Hydroxyzine
  4. Ramelteon
  5. Gabapentin
  6. Doxepin

Our medications have quick onset, helping you achieve the desired results in the shortest time possible. Your designated doctor will schedule routine online consultations to monitor your progress and adjust the treatment if necessary. Our expert can also provide valuable tips for improving your sleep hygiene.

How Kick Works

To begin your journey to restorative sleep with Kick, follow three easy steps:

  1. Go to our Sleep Visit page to start your brief consultation
  2. Enter your medical and sleep history to help us design treatment based on your needs
  3. Add your delivery and payment details

If our experts decide Kick isn’t the best solution to your sleep issues, you won’t pay for the initial consultation as per our Doctor Guarantee.

Kick’s sleep program has earned glowing reviews on Trustpilot, demonstrating its effectiveness.


Tramadol and Trazodone—Who Should and Shouldn’t Use These Medications?

Tramadol and trazodone are generally safe and effective, but they’re not for everyone. Check out the following table for more details:


Who Should Use It?

Who Shouldn’t Use It?


  • Adults suffering from moderate or severe pain

  • Individuals with sleep problems, especially when caused by pain 

  • Individuals for whom other forms of non-opioid pain relievers haven’t been helpful

  • Individuals with liver or kidney problems

  • Patients with intestinal blockage problems

  • People who recently used alcohol, MAOIs, narcotics, sedatives, or tranquilizers


  • Adults with major depressive disorder

  • Individuals with insomnia and anxiety issues

  • Patients with a history of heart attacks or heart disease

  • Individuals who used MAO inhibitors in the past 14 days

  • Individuals with a history of long QT

The lists above aren’t exhaustive. You should inform your healthcare provider about any chronic or recent medical conditions and procedures you’ve had before using these drugs.

Trazodone and Tramadol Alternatives

If your doctor decides that tramadol and trazodone aren’t safe and effective for your case, they may recommend the following medications:

Each alternative carries the risk of side effects or potential interactions, so you should consult your healthcare provider before switching medications.

Featured image source: Ron Lach