Can clonidine be used for sleep?

In this article:

• Is clonidine approved as a sleep aid?
• How much clonidine should I take for sleep?
• Advantages of taking clonidine for sleep
• Side effects of clonidine
• Clonidine alternatives

In this article

• Is clonidine approved as a sleep aid?
• How much clonidine should I take for sleep?
• Advantages of taking clonidine for sleep
• Side effects of clonidine
• Clonidine alternatives

Clonidine is a prescription medication that was originally intended to treat high blood pressure. Since its introduction 40 years ago, clonidine has grown in popularity, and medical professionals have found several other uses for the versatile drug. 

 These days, many doctors prescribe clonidine to help patients sleep better. If you’ve got a case of insomnia keeping you up at night, we’ve asked the experts everything to know about taking clonidine for sleep.

Is clonidine approved as a sleep aid?

The U.S. Food and Drug Administration (FDA) does not approve clonidine as a sleep aid.

“It is not approved in adults directly as a sleep aid, but it is often used ‘off-label’ as a non-controlled substance that aids in sleep,” explains Dr. Sulagna Misra, MD, BCMAS, founder of Misra Wellness. 

Clonidine, a centrally-acting alpha-2 adrenergic agonist, was FDA-approved as an antihypertensive drug to treat high blood pressure and lower heart rate. It inhibits the release of the hormone norepinephrine, which in turn relaxes arteries and improves the blood supply to the heart. Clonidine is the generic name, but it may be sold under its brand name, Catapres, which is primarily formulated with clonidine hydrochloride.

There are some other FDA-approved indications for clonidine, including treatment of pediatric attention-deficit/hyperactivity disorder (ADHD) for children who cannot take stimulants, reducing irritability in kids with autism, reducing tics in those with Tourette’s syndrome, and managing pain related to cancer.

Clonidine also works as a sedative. Doctors have found that clonidine can be an effective pharmacologic intervention for improved sleep quality in patients with insomnia and sleep disturbances. 

While the FDA has not approved clonidine for treating insomnia, it is prescribed “off-label,” meaning that it is prescribed for purposes that are not officially approved by the FDA.

How much clonidine should I take for sleep?

A typical dose of clonidine is between 0.1mg to 0.3 mg. It’s best to take this an hour or two before bedtime.

“The optimal dosage can vary substantially between individuals based on factors like age, kidney function, and sensitivity to the medication,” explains Dr. Farhan Malik, MD, Senior Medical Director at Prometheus by Dr. Malik.

Since it’s better to start low and see how your body adjusts, it’s common to start at 0.1 mg of clonidine and then increase the dosage as needed over several days.

Advantages of taking clonidine for sleep

There are many advantages of taking clonidine for improved REM sleep. First and foremost, clonidine helps individuals sleep, which is important for overall health. 

“One advantage of using clonidine for sleep is its ability to promote drowsiness and improve sleep onset,” says Dr. Malik. He further explains, “It works by stimulating alpha-2 adrenergic receptors in the brain, which can help calm the nervous system and induce relaxation conducive to sleep.”

Though it’s not fast-acting, clonidine usually begins working for sleep within one to two hours after taking it. Clonidine has immediate-release and extended-release options, so the latter could be a better option for those who can’t stay asleep throughout the night. While immediate-release clonidine is less helpful for those who can’t stay asleep at night, one study found that clonidine helped participants sleep five to nine hours each night based on their dosage.

Even though clonidine’s effectiveness as a sleep aid still needs further study, researchers in 2022 determined, after controlled studies, that “clonidine is a viable option for clinicians treating children and adolescents with sleep disorders.”

One of the biggest benefits of clonidine is that, unlike many prescription drugs for insomnia, it is not a controlled substance and is relatively affordable.

Side effects of clonidine

“There are potential side effects to consider when taking clonidine for sleep,” says Dr. Malik.

Side effects of clonidine are typically short-term, as there are minimal long-term side effects associated with the drug. Common side effects of clonidine may include:

• Dizziness
• Dry mouth
• Constipation
• Erectile dysfunction
• Hypotension or low blood pressure
• Fainting and falling
• Slowed heart rate

Both Dr. Malik and Dr. Misra warn against stopping clonidine without the supervision of a doctor. Dr. Malik explains, “Abrupt discontinuation of clonidine can lead to rebound hypertension, so it is important to follow a tapering schedule if you are stopping the medication.”

Dr. Misra explains other potential issues of quitting clonidine cold turkey. “Stopping the medication may result in sweating, flushing, difficulty sleeping, and insomnia,” she says.

Some medications may interact with clonidine. You should use caution when taking clonidine if you’re on other high blood pressure medications, diuretics, medications for mood disorders, or medications that cause drowsiness. It’s important to discuss these possible interactions with your healthcare provider by giving them a complete list of all the medications you currently take, both prescription and over-the-counter (OTC).

Clonidine is not indicated for patients who are pregnant or breastfeeding. Patients with heart issues, kidney disorders, and blood circulation disorders should also use caution when taking clonidine.

Clonidine alternatives

“Sleep is very complex, and there are many different medications, classes, or combinations that may help with sleep, depending on the sleep issue,” explains Dr. Misra.

If clonidine doesn’t work as a sleep aid or you’re looking for an alternative, our chart below lists common sleep medications that may be able to help.

*Rx represents a prescription medication, and OTC represents an over-the-counter medication.

There are popular sleep medication choices that have serious side effects. Benadryl, a first-generation antihistamine, causes sleepiness, but long-term use could lead to an increased risk of dementia. Benzodiazepines, like Valium and Xanax, are also known to help with sleep problems, but these can be habit-forming and are best for short-term use.

“Non-drug options like cognitive behavioral therapy for insomnia, sleep hygiene techniques, meditation, and exercise can also help improve sleep,” says Dr. Malik. “Ultimately, the best alternative depends on your specific sleep difficulties and medical conditions.”