Sleep aids: Understand options sold without a prescription

You've followed the usual tips for getting enough sleep. You have a regular sleep schedule, avoid caffeine and daytime naps, and exercise regularly. You also avoid lighted screens before bed and have tried to reduce your stress. Still, it's been weeks since you've had a good night's sleep. Is it time for a sleep aid you can get without a prescription? Here's what you need to know if you're considering medicine to help you sleep.

Most sleep aids available without a prescription contain antihistamines. Tolerance to the effects of antihistamines can develop quickly. The longer you take them, the less likely they are to make you sleepy.

In addition, these medicines can leave you feeling groggy and unwell the next day. This is the so-called hangover effect.

If you take other medicines, sleep aids may affect how those medicines work. Also, much is still unknown about the safety and effectiveness of sleep aids available without a prescription.

Sleep aids available without a prescription are widely available. Common choices and the potential side effects include:

• Diphenhydramine (Benadryl). Diphenhydramine is an antihistamine that can make you sleepy. Side effects might include daytime drowsiness, dry mouth, constipation and urinary retention.
• Doxylamine (Unisom). Doxylamine is also a sedating antihistamine. Side effects are similar to those of diphenhydramine and may include daytime drowsiness, dry mouth, constipation and urinary retention.
• 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 headaches, nausea and daytime sleepiness.
• Valerian. Supplements made from this plant are sometimes taken as sleep aids. Although a few studies show some therapeutic benefit, other studies haven't found the same benefits. Side effects appear to be mild and may include headache and weakness.

Generic versions with the same active ingredients as brand-name sleep aids are commonly available. Generics have the same risks and benefits as their brand-name counterparts. They are often available at a more reasonable cost.

When using sleep aids you can buy without a prescription, follow these steps:

• Start with your healthcare team. Ask your healthcare professional if the sleep aid might interact with other medicines or underlying conditions. Also ask what dosage to take.
• Keep precautions in mind. Diphenhydramine and doxylamine aren't recommended for people who have certain health conditions. These include closed-angle glaucoma, peptic ulcer and urinary retention. In addition, sleep aids pose risks for people who are pregnant or breastfeeding, and they might pose risks for people over age 65, including an increased risk of dementia.
• Take it one day at a time. Sleep aids you can get without a prescription might be a temporary solution for sleep problems. However, they're not intended for long-term use.
• Avoid alcohol. Never mix alcohol and sleep aids. Alcohol can increase the sedative effects of the medicine.
• 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, talk to your healthcare team. In addition to lifestyle changes, behavioral therapy may be recommended. It can help you build better sleep habits and make your bedroom more comfortable for sleeping. In some cases, short-term use of prescription sleep aids might be recommended as well.