How BuSpar could help you sleep

In this article:

• Buspirone for sleep
• When to take it
• Dosage
• Risks
• Alternatives

In this article

• Buspirone for sleep
• When to take it
• Dosage
• Risks
• Alternatives

You’re staring at the ceiling in the middle of the night, counting sheep, but instead of lulling you into a peaceful slumber, they won’t stop jumping around in your mind. If you regularly struggle with sleep issues, finding the right solution can feel like finding a needle in a haystack.

Pharmaceutical options such as benzodiazepines like diazepam and antidepressants like trazodone are sometimes used off-label to treat insomnia in adults. Another drug that’s sometimes prescribed is buspirone hydrochloride, an anxiolytic medication that’s approved by the U.S. Food & Drug Administration (FDA) to treat generalized anxiety disorder. Previously sold under the brand name BuSpar, its main purpose is to alleviate symptoms of anxiety. It can help with sleep troubles in certain individuals—although the typical dosage varies. If you’re wondering if BuSpar can help you sleep, keep reading.

Does buspirone help you sleep? 

It depends. Buspirone does not have a sedating effect, according to Raj Dasgupta, MD, sleep specialist and program director at Huntington Health Hospital in California. In other words, it won’t make you sleepy.

According to research, buspirone may even have stimulant properties, making it harder to fall asleep if you take it close to bedtime. For this reason, Dr. Dasgupta says buspirone isn’t typically a first-choice off-label (prescribed for a different purpose than its FDA-approved uses) medication for sleep.

However, for patients whose insomnia is linked to anxiety, buspirone works as an indirect sleep aid, says Sazan Sylejmani, Pharm.D., owner and pharmacy manager at Westmont Pharmacy in Illinois. If your prescribing healthcare provider recommends buspirone for sleep, taking it before bed is not advised—instead of making you sleepy, it may increase alertness. Rather, it may help improve sleep quality over time by addressing underlying anxiety, notes Dr. Sylejmani.

“Buspirone treats anxiety by balancing the levels of dopamine and serotonin in your brain, neurotransmitters (chemical messengers) that help regulate mood,” explains Dr. Dasgupta. Low levels of dopamine and serotonin are linked with anxiety symptoms. As a partial serotonin receptor agonist, buspirone targets serotonin receptors, enhancing the effects of serotonin, known as the “feel-good chemical,” in the brain. It affects dopamine receptors via the mesolimbic pathway, which is involved in mood regulation and reward, improving mental health.

When should I take buspirone for sleep?

“Buspirone exhibits a unique pharmacologic profile in that it alleviates anxiety without causing sedation,” says Dr. Dasgupta. In other words, it won’t “knock you out.” In fact, you should take it during the day since it has some alerting properties—and even then, it won’t start working immediately. Over time, as buspirone reduces anxiety, it helps your mind and body to relax, leading to a better night’s sleep.

You may start to experience buspirone’s initial effects in one to two weeks, but the medication can take up to four to six weeks to reach its full effect. You’ll know buspirone is working when you start to experience less anxiety and, consequently, better sleep.

How will the Rx make you feel? You might experience the following common side effects of buspirone:

• Nausea
• Headache
• Changes in dreams
• Dizziness
• Drowsiness
• Lightheadedness

Rare but serious side effects include:

• Changes in weight or appetite
• Fainting
• Blood pressure changes
• Muscle spasms or cramps
• Eye redness or itching
• Allergic reaction (trouble breathing, hives, swelling of the tongue, lips, or face, chest pain, changes in heart rate, slurred speech, blurred vision, confusion, tingling or numbness in the hands, arms, feet, or legs, or uncontrollable movements)

Buspirone dosage for sleep

Since buspirone isn’t FDA approved for sleep, there is no standard dose used for this purpose, informs Dr. Sylejmani. However, the anxiety medication is available in 5, 7.5, 10, 15, and 30 mg tablet doses. For the treatment of anxiety in adults, a total daily dose of 20 to 30 mg divided into two to three doses per day is common. (For example, someone may take 10 mg twice daily for a total daily dose of 20 mg.)

Risks of taking buspirone for sleep

While buspirone is generally well-tolerated and safe when taken long-term, patients with certain medical conditions and those taking specific medications should avoid the medication. For example, kidney or liver disease patients and pregnant or breastfeeding women should consult a healthcare professional for medical advice before taking buspirone.

Known drug interactions with buspirone include:

• Monoamine oxidase inhibitors (MAOIs), such as phenelzine and selegiline, can lead to dangerously elevated blood pressure or serotonin syndrome when taken within two weeks of buspirone.
• Selective serotonin reuptake inhibitors (SSRIs) like sertraline and fluoxetine can increase the risk of serotonin syndrome.
• Calcium channel blockers like diltiazem and verapamil can change blood levels of buspirone.
• Antibiotics like erythromycin and rifampin can change blood levels of buspirone.
• Anticonvulsants like phenytoin can change blood levels of buspirone.

Dr. Sylejmani adds that grapefruit juice can increase the amount of buspirone in the blood, so it should be avoided.

Alternatives to buspirone for sleep

If buspirone doesn’t seem like the right fit, alternative treatment options exist for managing sleep issues. Common options include melatonin, trazodone, and hydroxyzine, as well as short-term use of over-the-counter sleep aids like diphenhydramine.

Common daily doses and side effects are as follows:

• Melatonin: 1 to 10 mg; daytime sleepiness, headache, dizziness, and nausea
• Trazodone: 25 to 100 mg; drowsiness, weight gain, sexual dysfunction, and urinary incontinence
• Hydroxyzine: 25 to 100 mg; drowsiness and dry mouth
• Diphenhydramine: 25 to 50 mg; sleepiness, dry nose, mouth, or throat, and upset stomach

While medications can help, cognitive behavioral therapy for insomnia (CBT-I) is the first line of treatment. “CBT-I is a 6–8 week treatment plan that helps you learn to fall asleep faster and stay asleep longer by changing your sleep habits and addressing the underlying causes of insomnia,” Dr. Dasgupta explains. He adds that CBT-I can be a good choice if you have long-term sleep problems, are worried about becoming dependent on sleep medications, or if medicines aren’t effective or cause side effects.

The bottom line? While BuSpar may not be a conventional sleep aid, its role in managing anxiety can improve sleep for some individuals. “Always speak with your healthcare provider before starting, stopping, or switching medications,” says Dr. Dasgupta.