Trouble sleeping? Over-the-counter sleep aids might help temporarily — but lifestyle changes are usually the best approach for chronic insomnia.By Mayo Clinic Staff
You've followed the usual tips for getting enough sleep — sleeping on a regular schedule, avoiding caffeine and daytime naps, exercising regularly, avoiding lighted screens before bed, 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.
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.
Over-the-counter sleep aids are widely available. Common choices and the potential side effects include:
- Diphenhydramine (Benadryl, Aleve PM, 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 headaches 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. Ask your doctor if the sleep aid might interact with other medications or underlying conditions, and what dosage to take.
- 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. In addition, sleep aids pose risks for women who are pregnant or breast-feeding, and might pose risks to people over age 75, including an increased risk of strokes and dementia.
- 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, talk to your doctor. In addition to lifestyle changes, he or she 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.
Feb. 17, 2018
- Bonnet MH, et al. Treatment of insomnia in adults. https://www.uptodate.com/com/contents/search. Accessed Jan. 9, 2018.
- Schroeck JL, et al. Review of safety and efficacy of sleep medicines in older adults. Clinical Therapeutics. 2016;38:2340.
- Culpepper L, et al. Over-the-counter agents for the treatment of occasional disturbed sleep or transient insomnia: A systematic review of efficacy and safety. The Primary Care Companion for CNS Disorders. 2015;17:1. http://www.psychiatrist.com/PCC/article/Pages/2015/v17n06/15r01798.aspx. Accessed Jan. 9, 2018.
- Kryger MH, et al., eds. Pharmacologic treatment of insomnia: Other medications. In: Principles and Practice of Sleep Medicine. 6th ed. St. Louis, Mo.: Elsevier Saunders; 2017. https://www.clinicalkey.com. Accessed Jan. 3, 2018.
- Petrov ME, et al. Over-the-counter and prescription sleep medication and incident stroke: The Reasons for Geographic and Racial Differences in Stroke study. Journal of Stroke and Cardiovascular Disease. 2014;23:2110.
- Valerian. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Jan. 9, 2018.
- Ferri FF. Insomnia. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Jan. 10, 2018.
- Melatonin. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Jan. 10, 2018.
- Dauphinot V, et al. Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders. Alzheimer's Research and Therapy. 2017;9:58.
- Rochon PA. Drug prescribing for older adults. https://www.uptodate.com/contents/search. Accessed Jan. 9, 2018.