So I have some experience with this and have a few things I want to tell you:

• Consider a dedicated sleep study. If you have sleep apnea, medication will not fix your problem and some medications may actually make it worse.

• Xanax (an anxiety medication) and Ambien (a sleep medication) are very similar drugs with respect to their mechanism of action. Xanax binds to a specific group of receptors to cause anxiolytic effects and happens to also make you sleepy. Ambien binds to a subset of those same receptors to make you sleepy, but don’t have the strong anxiety reducing effect. If Xanax works for you, Ambien should theoretically have a similar effect. In practice, it doesn’t tend to work as well because anxiety can keep you awake. If that has been your experience with Ambien, think about taking some steps to address anxiety even if you don’t think it’s that bad. Yoga, counseling, meditation, whatever. There are also guided breathing audio through apps like Fitbit and calm that may be helpful.

• You can also supplement a prescription sleep aid with something non prescription, which is what I do. I take Ambien, and to keep my dose low I supplement with melatonin, tryptophan, and valerian root when I need an extra kick into sleepiness. I’ve heard CBD is also quite effective for this. Magnesium reportedly also helps with restful sleep, but get a sleep formulation because magnesium in the wrong form causes diarrhea.

• Don’t underestimate sleep hygiene. For a long time I had the attitude of “I have real sleep problems, basic stuff like cutting back caffeine is not going to help.” The thing is, when taken together, that kind of stuff actually can help tremendously. I scheduled a month where I went hardcore on sleep hygiene. Strict caffeine limits, no late caffeine or exercise, don’t do anything on your bed but sleep and sex, wake up at the same early time every day even when you don’t have to, limit screens before, bed… I mean ALL of it. I found that it actually really helped. In combination with medication it might be a life saver.

Good luck!