You've followed the usual tips for getting enough sleep—sleeping on a regular schedule, avoiding caffeine and daytime naps, exercising regularly, and managing stress. Still, it's been weeks and a good night's sleep remains elusive. Is it time for an over-the-counter sleep aid? Here's what you need to know if you're considering medication to help you sleep.
Sleep aids: Not a magic cure
Over-the-counter sleep aids can be effective for an occasional sleepless night. There are a few caveats, however.
Most over-the-counter sleep aids contain antihistamines. Tolerance to the sedative effects of antihistamines can develop quickly—so the longer you take them, the less likely they are to make you sleepy.
In addition, some over-the-counter sleep aids can leave you feeling groggy and unwell the next day. This is the so-called hangover effect.
Medication interactions are possible as well, and much remains unknown about the safety and effectiveness of over-the-counter sleep aids.
Sleep aids: The options
Over-the-counter sleep aids are widely available. Common choices and the potential side effects include:
- Diphenhydramine (Benadryl, Unisom SleepGels, others). Diphenhydramine is a sedating antihistamine. Side effects might include daytime drowsiness, dry mouth, blurred vision, constipation, and urinary retention.
- Doxylamine succinate (Unisom SleepTabs). Doxylamine is also a sedating antihistamine. Side effects are similar to those of diphenhydramine.
- Melatonin. The hormone melatonin helps control your natural sleep-wake cycle. Some research suggests that melatonin supplements might be helpful in treating jet lag or reducing the time it takes to fall asleep—although the effect is typically mild. Side effects can include headache and daytime sleepiness.
- Valerian. Supplements made from this plant are sometimes taken as sleep aids. Although a few studies indicate some therapeutic benefit, other studies haven't found the same benefits. Valerian generally doesn't appear to cause side effects.
Store brands containing the same active ingredients as brand-name sleep aids are commonly available, too. Store brands have the same risks and benefits as their brand-name counterparts, often at a more reasonable cost.
When using over-the-counter sleep aids, follow these steps:
- Start with your doctor. You don't need your doctor's OK to take an over-the-counter sleep aid. But it's a good idea to ask if the sleep aid might interact with other medications or underlying conditions, and to determine the best dosage. In addition, sleep aids pose risks for women who are pregnant or breast-feeding, and might pose risks to people over age 75, including the risk of stroke.
- Keep precautions in mind. Diphenhydramine and doxylamine aren't recommended for people who have closed-angle glaucoma, asthma, chronic obstructive pulmonary disease, sleep apnea, severe liver disease, digestive system obstruction, or urinary retention. These drugs are also not recommended for older adults because they may increase the risk of dementia. They can also cause numerous side effects in older adults, such as confusion, hallucinations, dry mouth, blurred vision, constipation, nausea, impaired sweating, inability to empty the bladder completely (urinary retention), and rapid heart rate (tachycardia).
- Take it one day at a time. Over-the-counter sleep aids are a temporary solution for insomnia. Generally, they're not intended to be used for longer than two weeks.
- Avoid alcohol. Never mix alcohol and sleep aids. Alcohol can increase the sedative effects of the medication.
- Beware of side effects. Don't drive or attempt other activities that require alertness while taking sleep aids.
Everyone benefits from a good night's sleep. If you continue to have trouble sleeping, consult your doctor for additional help. In addition to lifestyle changes, your doctor might recommend behavior therapy to help you learn new sleep habits and ways to make your sleeping environment more conducive to sleep. In some cases, short-term use of prescription sleep aids might be recommended as well.
Publication Date: 2007-12-08