Xanax (alprazolam) will cause sedation, drowsiness and somnolence as a side effect but is not typically prescribed to help with insomnia (trouble sleeping) on a regular basis.
- Xanax may be used on a short-term basis to help with symptoms from anxiety disorders and anxiety due to depression, until preferred treatments, such as serotonin reuptake inhibitors (like SSRIs), take effect. At that time, Xanax should be slowly discontinued to help prevent withdrawal symptoms.
- Xanax is also used to treat panic disorders with or without agoraphobia (fear of places and situations that might cause panic, helplessness, feeling trapped or embarrassment).
If you have discontinued treatment with Xanax at your doctor's instructions, and are experiencing insomnia, contact your healthcare provider. Insomnia, or trouble sleeping, can be a temporary withdrawal side effect when Xanax treatment is discontinued. Your doctor may decide to more slowly discontinue your treatment.
Common central nervous system (CNS) side effects associated with Xanax can include:
- Confusion
- Anxiety
- Drowsiness
- Dizziness
- Fatigue
- Decreased alertness
- Trouble sleeping
- Memory trouble
- Trouble and slowing with balance, walking or talking (ataxia, psychomotor impairment)
The sedating effect of Xanax can impair the ability to drive safely, operate equipment or perform other hazardous activities. Do not engage in these activities until you know how this medicine will affect you. Sedation usually occurs quickly, within 15 to 45 minutes after taking a dose of Xanax.
As Schedule IV controlled substances, all benzodiazepines have the potential for abuse, addiction and diversion.
Xanax can slow or stop your breathing, especially if you have recently used an opioid (“narcotic”) medication or alcohol. A person caring for you should seek emergency medical attention (call 911 in the US) if you have slow or shallow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Sedation or sleepiness due to Xanax may be a greater risk if you are:
- An older age
- Using higher doses
- Taking other medicines that affect the central nervous system
- Increasing your dose too quickly
- Drinking alcohol or abusing illicit drugs
Do not drink alcohol while taking Xanax. Use caution to avoid falling or an accidental injury, especially for older patients.
Related: Benzodiazepines: Overview and Use
What else can I use besides Xanax for sleep?
First, be sure to assess your sleep habits. For example, you should avoid caffeine late in the day, limit use of electronics within 1-2 hours before bedtime, and avoid alcohol beverages late in the evening, which may lead to early awakening. If exercise is stimulating for you, schedule your workouts for earlier in the day.
While some benzodiazepines are approved by the FDA to help with sleep, many healthcare providers do not use these medicines as initial treatments due to other prescription options that may be safer, such as:
- Nonbenzodiazepines or “Z-drugs”: for example, eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Ambien CR, Edluar, Zolpimist)
- Dual orexin receptor antagonists (DORAs): for example, daridorexant (Quviviq), lemborexant (Dayvigo), and suvorexant (Belsomra)
- Doxepin (Silenor): a tricyclic antidepressant with histamine receptor antagonist properties
- Ramelteon (Rozerem): a melatonin receptor agonist
The primary disadvantage of benzodiazepines like Xanax is the risk of abuse, dependence, and overdose (especially when combined with opiates). Your doctor will select your insomnia treatment based on patient-specific factors, such as dosing, possible side effects, drug interactions, and cost.
This is not all the information you need to know about Xanax (alprazolam) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.