OpenHealth Q&A

Do Side Effects of Trazodone for Insomnia Diminish Over Time?

I've been struggling with depression for approximately two years. Recently, over the last few weeks, I've found myself waking up after just 3 to 5 hours of sleep and unable to drift back off. Generally, I require around 7 to 8 hours to feel truly rested. Additionally, I have been managing gastroesophageal reflux disease (GERD) for most of my adult life, which has contributed to my ongoing challenges with maintaining a consistent sleep schedule. As a result, difficulty falling asleep is something I am quite familiar with. To assist me in achieving better sleep patterns, my doctor prescribed trazodone. I began taking the medication last week, starting with 50 mg for three days, followed by an increase to 100 mg for the next two nights. This treatment did aid in prolonging my sleep duration somewhat, though I still typically woke after about five hours to use the bathroom. Fortunately, I was able to fall back asleep quickly, and I managed to get over eight hours of sleep on most nights during that week. However, I did experience some disconcerting side effects, such as dizziness and a general sense of being somewhat uncoordinated throughout the day. I often felt as if I were functioning on autopilot and was more fatigued than usual, as if I had only slept for about four hours without medication. This past weekend, knowing that I would be drinking at a gathering, I decided to pause my trazodone usage for two nights beforehand. At the party, I performed a few songs with a friend on guitar, but I was dissatisfied with my performance. In the days leading up to the event, I had realized that I struggled with guitar pieces I had played well for two decades. It felt as though the medication had dulled my cognitive functions, making complex tasks harder to recall or execute properly. Since then, I haven't taken any trazodone and after four nights without it, I found myself feeling more capable and motivated, ready to tackle my work. It was uplifting, although I did notice that during short breaks, I would quickly feel an overwhelming fatigue—as is typical for me. Reflecting on similar experiences, I recall going through a phase of insomnia leading up to my Master's defense while I was 36, which I attribute to anxiety. I continue to feel a degree of anxiety concerning my depression and various personal issues. This leads me to wonder—are the adverse effects of trazodone sleep preferable to just 3-5 hours of natural sleep, accompanied by an occasional, extended nap? Moreover, do the side effects of trazodone tend to lessen with continued use? I plan to discuss these concerns with my doctor as well, although her response times can be slow, and it might be several weeks before I hear back.

Answers (1)

6/17/2025, 5:02:01 PM

OpenHealth AI

It sounds like you’re facing multiple challenges with sleep and how medications affect your daily life. It's important to address both your sleep concerns and the side effects of trazodone. Here's a clear breakdown based on what you've shared:

Main Points

1. Trazodone can have side effects, including dizziness and cognitive dulling, especially when you start the medication.
2. Side effects may diminish over time, but it's essential to weigh the benefits against how they affect your daily life.
3. There are strategies you can try to improve your sleep without relying solely on medication.

Explanation

Trazodone is often prescribed for insomnia due to its sedative effects, but it can come with side effects such as dizziness, fatigue, and cognitive impairment, especially when beginning treatment. Some people notice that these effects lessen within a couple of weeks as their bodies adjust, while others may find them persist. Given your history of depression and insomnia, it’s understandable to be cautious about medications that affect your cognitive abilities, especially in high-pressure situations.

Next Steps

1. Monitor Side Effects: If you decide to restart trazodone, keep a detailed journal of how you feel each day. Note sleep duration, quality, and any side effects you experience. This will aid in discussions with your doctor.

2. Hydration and Nutrition: Ensure you’re adequately hydrated and maintain a balanced diet. Both can significantly impact sleep quality and cognitive function.

3. Sleep Hygiene: Focus on good sleep habits. This includes:

   • Maintaining a consistent sleep schedule by going to bed and waking up at the same time daily.
   • Creating a restful environment (e.g., dark, quiet, and cool room).
   • Limiting screen time and stimulants (like caffeine) in the evening.

4. Consider Naps Wisely: It’s fine to take short naps if you feel excessively tired, but keep them brief (20-30 minutes) to avoid interfering with nighttime sleep.

5. Relaxation Techniques: Incorporate relaxation practices, such as deep breathing, meditation, or gentle yoga, especially before bed, which may help calm your anxiety and improve sleep quality.

Lastly, I encourage you to keep an open line of communication with your healthcare provider about your experiences and concerns. This will be vital in adjusting your treatment plan effectively. Remember, you don't have to navigate this alone, and finding the right strategies can take some time.