If you struggle to sleep, you know how much it can affect your daily life. It’s frustrating to lie awake night after night, watching the clock tick. Insomnia (trouble falling asleep, staying asleep, or both) is very common.
When lifestyle changes and better sleep habits aren't enough, health care providers sometimes recommend a prescription sleep medicine. Two of the most common prescriptions are Ambien (zolpidem) and Lunesta (eszopiclone).
If your health care provider has mentioned either of these medicines, you probably have questions. Are they the same? Which one will work better for you? How well a medicine works for you is a personal experience. Since there are no large studies that directly compare these two medicines, your choice will come down to differences in how they work, how long they last, and your body’s reaction.
The Basics: What They Have in Common
While Ambien and Lunesta have different active ingredients, both of these drugs are prescribed to help adults with insomnia fall asleep and stay asleep.
Ambien and Lunesta are both part of a family of drugs called sedative-hypnotics. They are often called "Z-drugs" because their generic names contain the letter Z and they help you get ZZZs. They work by helping to calm down your brain activity. They do this by interacting with a natural chemical in your brain called GABA, which acts like your brain’s natural “off switch.” This interaction makes it easier for you to relax and fall asleep.
Both carry a serious FDA warning for dangerous, complex sleep behaviors like sleepwalking or sleep-driving. Both are controlled substances because they can be abused or lead to dependence. If you become dependent on a prescription sleep medicine, you may experience symptoms such as tolerance and withdrawal. Tolerance means your body has gotten used to the medicine over time and you may feel like you need a higher dose to get the same effect. You may experience withdrawal if you suddenly stop taking the medicine. Withdrawal symptoms may include anxiety, shakiness, or trouble sleeping that is worse than before.
If you feel like your sleep medicine is not working, talk to your health care provider. Do not increase the dose yourself. You should also talk to your health care provider about the safest way to stop your medicine. Depending on how long you have been taking it, you may need to slowly lower your dose before stopping completely.
Food can change how quickly both medicines start to work. To help you fall asleep faster, take Ambien on an empty stomach and avoid taking Lunesta with or right after a heavy, high-fat meal. Do not take Ambien or Lunesta if you have had alcohol in the evening or before going to bed. Sleepiness, dizziness, and next-day sleepiness can be worse if you drink alcohol while taking these medicines.
Both medicines can cause grogginess or trouble thinking clearly the next day. Always make sure you have a full seven to eight hours set aside for sleep after taking your dose.
Key Differences You Should Know
While these two medicines are in the same family, they have several important differences that may make one a better choice for your specific needs.
How long it lasts
This is the biggest difference and often determines who gets prescribed which medicine.
For trouble falling asleep only. Ambien (immediate release): The immediate-release (IR) form of Ambien acts quickly but leaves the body faster. This makes Ambien IR a good choice if your only problem is trouble falling asleep.
For trouble falling and staying asleep. Lunesta and Ambien CR stay in your system for a longer period of time, making them better choices if you struggle to both fall and stay asleep throughout the night.
- Lunesta: It has been shown to provide seven to eight hours of sleep. But this longer action may also increase the risk of feeling groggy or drowsy the next day.
- Ambien CR: This is made up of two layers that make its effect last longer than Ambien IR. The first layer dissolves quickly right after you take the pill, helping you fall asleep, while the second layer dissolves slowly over several hours to help you stay asleep (averaging six to seven hours).
Like Lunesta, Ambien CR carries a higher risk of next-day grogginess because it remains in your system longer than regular Ambien.
Side effects
While many general side effects are similar for Ambien and Lunesta, there is one major difference: taste. Lunesta is well known to cause a metallic or bitter taste in your mouth. This side effect may make it difficult for some people to tolerate Lunesta. Ambien does not commonly cause this taste.
Dosing
For Ambien, health care providers typically prescribe a lower dose for women than they do for men because some women's bodies process the medicine more slowly. Lunesta dosing is not typically adjusted based on sex in the same way.
Who Should Take Which Medicine?
You and your health care provider can decide which medicine is right for you by looking at your specific sleep problem, your health history, and what other medicines you take.
A health care provider may lean toward Ambien IR if:
- Your only problem is falling asleep. The quick action of the immediate-release tablet can help you start your sleep cycle.
- You cannot tolerate the bitter taste caused by Lunesta.
A health care provider may lean toward Lunesta or Ambien CR if:
- You have trouble staying asleep. The longer-lasting nature of Lunesta or Ambien CR is helpful for maintaining sleep throughout the whole night.
The key message is that the final choice between the two medicines is a decision you and your health care provider must make together.
Quick Summary/Key Takeaways
- Ambien and Lunesta are both "Z-drugs" used to treat insomnia by calming your brain.
- The main difference is duration. Ambien IR is for people who have trouble falling asleep. Lunesta or Ambien CR both help with falling asleep and staying asleep.
- Taste is a factor for some people. Lunesta is associated with an unpleasant or metallic taste in the mouth.
- Both have serious warnings. They can cause complex sleep behaviors like sleepwalking, and they carry a risk of dependence. If you experience memory loss or unusual behavior, call your health care provider.
- Talk to your health care provider. Your personal sleep pattern, health history, and tolerance for side effects are the only things that will determine which drug is right for you.
