Trazodone for Insomnia and Comorbid Depression: Are the AASM Guidelines Relevant?

A recent meta-analysis found trazodone significantly improves sleep quality and depressive symptoms in patients with comorbid depression, distinguishing this population from those with primary insomnia. Polysomnographic data showed trazodone increases restorative stage 3 and 4 sleep while reducing stage 1 sleep, potentially addressing the reduced slow-wave sleep characteristic of major depression pathophysiology. Trazodone is an effective option for depression-associated insomnia. Prescribers must monitor for common side effects like blurred vision and somnolence.