What to Know About Over-the-Counter Sleep Aids – Cleveland Clinic

It’s late. It’s dark. You’re tired. (So tired.) So why – why – are you still staring at the ceiling, wide awake?

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If you’re experiencing insomnia, a pill to make you sink into dreamland sounds like magic. Drugstore shelves are lined with medications and supplements that promise a good night’s sleep. But do they work? And are they safe?

Family medicine doctor Matthew Goldman, MD, gives us the lowdown on common over-the-counter sleep aids.  

Diphenhydramine and doxylamine (antihistamines)

What they are

Both diphenhydramine and doxylamine are antihistamines, medications that are often used to fight allergies. But diphenhydramine and doxylamine are part of a family of antihistamines that can act on your central nervous system and have a sedating effect. In other words, they can make you sleepy.

You can find diphenhydramine and doxylamine in many over-the-counter sleep aids. Diphenhydramine is the snooze-inducing ingredient in drugs like:

• Benadryl®.
• Unisom®.
• Advil PM®.

Doxylamine is found in products such as:

• Unisom® SleepTabs.
• Tylenol® Cold and Cough Nighttime.
• Vicks NyQuil® Cough.

Side effects

These drugs affect people differently. Some have few side effects while others aren’t so lucky. “Older patients are often more sensitive to side effects, so they should limit or avoid using these products,” Dr. Goldman says. Possible side effects include:

• Agitation or nervousness.
• Dizziness.
• Nausea.
• Constipation.
• Dry mouth.
• Headache.

Call your doctor immediately if you have these serious side effects:

• Vision problems.
• Urination problems.

How to use it

Follow the dosage instructions on the package and don’t mix the drugs with alcohol or other sedatives. Also, don’t take these drugs night after night. “These medications aren’t recommended for chronic insomnia, but they can help if you’re occasionally having trouble falling asleep,” Dr. Goldman says.

Melatonin

What it is

Melatonin is a hormone your brain makes. “Melatonin regulates your sleep-wake cycle,” Dr. Goldman explains. “The amount made by your body normally peaks at night, which causes you to feel sleepy.” If you’re having trouble sleeping, melatonin supplements might send you off to dreamland.

Side effects

Melatonin isn’t linked to major side effects, Dr. Goldman says. But there’s some evidence it may cause:

• Dizziness.
• Nausea.
• Headaches.
• Confusion.
• Fragmented sleep.

How to use it

In the United States, you can buy melatonin as a dietary supplement. The typical dose can range from 1 milligram to 10 milligrams. If you’re trying it for the first time, Dr. Goldman recommends starting with 1 milligram or even splitting a pill in half and taking just 0. 5 milligrams.

Once you see how it affects you, you might gradually increase your dose. “Talk to your healthcare provider to determine the right dose for you,” he says. “But in general, starting low and going slow is the best way to go for all medications and supplements.”

Melatonin is best for short-term treatment of insomnia. It’s also helpful for reducing jet lag when traveling and can help people who do shift work fall asleep at irregular hours. “It’s a safe choice, but don’t use it for more than three months at a time,” Dr. Goldman says. 

Valerian root

What it is

Valerian is an herbal supplement made from dried roots. It contains compounds that may act on receptors in the brain, potentially slowing down the nervous system and making you drowsy. “But it’s not completely known yet how valerian root works,” Dr. Goldman says. And it’s not a sure thing. Research studies testing how effective valerian is for insomnia have had mixed results.

Side effects

There are few reports of serious side effects from valerian, aside from feeling drowsy (a good thing if you’re taking it for insomnia). But some people may experience dizziness, Dr. Goldman says.

How to use it

Valerian is sold as a dietary supplement in tablet and capsule form. Follow the dosage instructions on the bottle. And like melatonin, it’s a good idea to start with a low dose. Since it’s a sedative, valerian could, in theory, slow down your breathing, Dr. Goldman adds — especially if you combine it with other medications. “Talk to your healthcare provider first, and avoid taking it with alcohol or other sedatives,” he says.

Sleep strategies that work (sleep aids not required)

If you have an occasional sleepless night, over-the-counter sleep aids can be a helpful short-term fix. But if insomnia is a regular thing, there are better strategies.

Dr. Goldman offers these tips to set yourself up for slumber success:

• Practice good sleep hygiene: “Maintain a regular bedtime and wake time routine. Get out of bed if you aren’t sleepy. And avoid alcohol, tobacco, stimulants and electronic devices before bed,” he says.
• Get regular exercise: A better night’s sleep is yet another benefit of exercise.
• Find the light: Get outside for a dose of sunlight, especially in the morning.
• See a counselor: Therapists can teach cognitive behavioral therapy for insomnia (CBT-I), a drug-free treatment to improve sleep. 
• Keep a diary: Dr. Goldman recommends keeping a sleep journal so you and your doctor can look for patterns to better understand when you sleep — and when you struggle. Armed with information, you can find the right path forward for a good night’s rest. “It’s always a good idea to talk to your doctor or a sleep specialist before trying new sleep aids or supplements,” Dr. Goldman says.

It might take some effort to turn your insomnia around. But it’ll be worth it when you wake up bright-eyed and bushy-tailed after a deep, restful slumber.  

Amazon.com: Unisom Nighttime Sleep-Aid Doxylamine Succinate Tablets, 48 Count : Health & Household

Safety Information

Attention: Use only if tablet blister seals are unbroken. Child-resistant packaging. If difficult to open, use scissors.Do not use in children under 12 years of age.Ask a doctor before use if you have: A breathing problem such as asthma, emphysema or chronic bronchitis. Glaucoma.Trouble urinating due to an enlarged prostate gland.Ask a doctor or pharmacist before use if you are taking any other drugs.When using this product: Avoid alcoholic beverages. Take only at bedtime.Stop use and ask a doctor if: Side effects occur. You may report side effects to FDA at 1-800-FDA-1088.Sleeplessness persists continuously for more than two weeks. Insomnia may be a symptom of serious underlying medical illness.If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Ingredients

Doxylamine Succinate 25 mg (Nighttime Sleep-Aid)

Directions

Adults and children 12 years of age and over: take one tablet 30 minutes before going to bed; take once daily or as directed by a doctor. Children under 12 years of age: Do not use.Other information. Store at 20-25 degrees C (68 -77 degrees F).

Legal Disclaimer

Disclaimer: While we work to ensure that product information is correct, on occasion manufacturers may alter their ingredient lists. Actual product packaging and materials may contain more and/or different information than that shown on our Web site. We recommend that you do not solely rely on the information presented and that you always read labels, warnings, and directions before using or consuming a product. For additional information about a product, please contact the manufacturer. Content on this site is for reference purposes and is not intended to substitute for advice given by a physician, pharmacist, or other licensed health-care professional. You should not use this information as self-diagnosis or for treating a health problem or disease. Contact your health-care provider immediately if you suspect that you have a medical problem. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration.

Statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease or health condition.

Unisom SleepTabs Review

For the last two weeks, I’ve been trying Unisom SleepTabs – an antihistamine over the counter sleep aid that’s widely available in the United States.

I sometimes test new sleep aids for short periods, but before taking Unisom I hadn’t taken any for a month. My system was clear, my sleep not so great, so it was a good time to try it.

I also traveled to England in the second week, so it was a good opportunity to see if it would help with jet lag and sleeping away from home.

In summary, I found Unisom SleepTabs were effective in helping me sleep. However, the effect lessened as the days rolled by, and the hangover effect also increased.

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The first night

My first impression was that the Unisom SleepTabs are tiny, which makes them easier to swallow than some of the oversized (in my opinion) sleep aids out there. They have a faint taste, but it’s not too strong or unusual.

I took one and read my book in bed to see if I could detect any sedation. And I believe I started to feel drowsier than I normally would after around 30 minutes.

I turned out the light and fell asleep pretty quickly afterwards – I’d say within 5 to 10 minutes, which is good for me.

Only one waking in the night

I woke up once 3 hours after taking the SleepTab to go to the bathroom. I felt a little groggy, but was able to safely navigate my house and return to sleep.

I again fell asleep quickly, and didn’t wake again until 7 hours later. So far so good then.

Side effects the next morning

I woke up feeling mostly refreshed from getting 7 hours’ sleep, just with a slightly fuzzy head. It was similar to what I’ve experienced with other anti-histamine sleep aids, so didn’t surprise me.

Other than that, there were no discernable side effects after the first night.

The rest of the week

I was quite impressed with how well the Unisom SleepTabs worked on the following nights.

I seemed to sleep well on most nights of the first week. On two nights, I woke up a few times, but fell asleep relatively quickly again.

Only on one night did I wake up for a longer period in the night. But for me, 6 out of 7 nights with 7+ hours’ sleep is a good result.

The downside is that the hangover effect increased as the week progressed. By the end of the week, it seemed noticeably worse than the first couple of nights.

It would take a couple of hours to clear up completely in the morning. And although that’s still acceptable for me, it was concerning that the effect was building.

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The second week

I traveled from the U.S. back to the U.K. at the end of the first week to visit family and friends.

Interestingly, I stayed one night in a house with cats, which I’m allergic to. I also spent a couple of nights in a friend’s house which is notoriously dusty, and I’m allergic to house dust mite too!

As expected, the antihistamine did its traditional job of preventing me from sneezing and sniffling my way through the night in their houses.

As for my sleep, the sedation was still there but did start to reduce in effectiveness I thought. Tolerance develops when using antihistamines for sleep, and this was exactly what was happening.

More noticeable side effects

Towards the end of the second week, the next day hangover was very obvious. I was waking up feeling quite groggy, and it would take a couple of hours or longer for it to totally clear.

I also started to get a dry mouth, which would last pretty much all day. So for me, that was a clear sign that it was time to stop taking them.

Would I take Unisom SleepTabs again?

If was experiencing serious sleep problems, I would take them again for a couple of nights, but no longer.

They worked very well at the start, helping me fall asleep faster and stay asleep. And there were no serious side effects.

However, I definitely wouldn’t use them for more than a couple of nights at a time. For me, the tolerance built quite quickly, and the hangover effect along with it.

But overall, compared to many other over the counter and prescription sleep aids, I thought they were effective and relatively easy to take for a short period.

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Further information

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Unisom Sleeptabs ingredients

According to the patient information on the pack I bought in the U.S. the ingredients are:

• Doxylamine Succinate 25 mg (the active antihistamine ingredient that can cause drowsiness)
• Dibasic calcium phosphate
• FD&C blue no. 1 aluminum lake
• Magnesium stearate
• Microcrystalline cellulose
• Sodium starch glycolate

Who shouldn’t take it

Unisom advise that you consult a doctor if any of the following apply to you:

• You have a breathing problem, like asthma, emphysema or chronic bronchitis
• You have glaucoma
• You have trouble urinating due to an enlarged prostate gland
• You’re taking any other drugs
• You’re pregnant or breastfeeding

They also issue these warnings:

• Don’t give it to children under 12 years old
• Don’t drink alcohol at the same time
• Only take it at bedtime
• Stop taking them and consult a doctor if you have any side effects
• If your sleep problems continue for more than 2 weeks, you should speak to a doctor

If you’d like to double check the current advice, you can find the above information on the Unisom website Sleeptabs factsheet page.

You can also find information about the safety on the drugs. com factsheet. That site includes more about interactions with other drugs and conditions.

Elderly people and antihistamines

One point that isn’t included in the Unisom factsheet is that some medical sites state that elderly people should be more careful when taking antihistamines.

This is partly because they have anticholinergic activity. So elderly people with preexisting conditions related to anticholinergic activity should check with their doctor first.

If unsure of this point, elderly people might benefit from erring on the side of caution and checking with a doctor before taking Unisom.

Possible side effects

According to the Unisom website Q&A section, side effects can include:

• Dry mouth
• Dizziness
• Memory problems

Medical websites, like Mayo Clinic and WebMD, list additional side effects:

• Headache
• Constipation
• Stomach upset
• Blurred vision
• Worse coordination
• Dry mouth, nose or throat
• Irregular or fast heartbeat
• Ringing in the ears
• Mental or mood changes (e. g. hallucinations, confusion, irritability)
• Easy bruising/bleeding

Is it really safe?

Despite the somewhat scary list of possible side effects, most people tolerate Unisom well in short periods. And it’s considered GRAS/E (Generally Recognized as Safe and Effective) by the FDA.

Again though, if you experience any of these side effects, stop taking it and seek medical advice.

Your views

Have you taken Unisom SleepTabs before? What was your experience? Please let me know in the comments below!

The Potential Risks of Over-the-Counter Sleep Aids

Is there anything better than crawling into bed after a full day? Your body craves sleep. But it seems as soon as you pull the covers up, your mind immediately fights to stay awake. Over-the-counter (OTC) sleep aids work in a pinch to switch you into sleep mode. But long-term, could these medicines do you harm?

Salma Patel, MD, a sleep medicine specialist at Banner – University Medical Center Tucson offered advice to people who may rely on over-the-counter sleep aids for weeks or months at a time. “Most over-the-counter sleep aides have diphenhydramine, doxylamine, melatonin, valerian or chamomile as the active ingredients,” said Dr. Patel. “Each carries its own risks and benefits.”

OTC sleep aids can be broken down generally into two categories: medications and dietary supplements. Both are known to be relatively safe when taken as recommended.

Sleep aid medications

Diphenhydramine and Doxylamine

Some common examples of OTC sleep aids with these active ingredients include Tylenol PM, Nytol, Sominex, ZzzQuil and Unisom. These drugs are antihistamines, which you also find in Benadryl, Zyrtec and other common allergy medications. Antihistamines block certain chemicals in your brain, helping you relax and making you feel sedated. Tolerance to these active ingredients can be developed rather quickly, which tempts users to increase dosage beyond the recommendation.

Risks for sleep aid medications

Side effects associated with sleep aid medications include dry mouth, urinary retention, blurred vision, confusion and constipation. Dr. Patel added, “The use of these medications is especially concerning in older or elderly individuals as they may be at a higher risk for confusion, dizziness and falls.”

Many decongestants containing pseudoephedrine (Sudafed) and allergy medications ending in “D” (Claritin-D) can be dangerous to people with heart conditions and those on heart medication. The active ingredient constricts blood vessels and could put additional stress on the heart, especially when used long-term. Since many of these are labeled as “drowsy,” some may consider taking them as a sleep aid. This should be avoided. Diphenhydramine and doxylamine, which are antihistamines, are generally safe for the heart. You can learn more about your heart health by taking our Heart Age Test.

Additionally, sleep aid medications often pair the active ingredient for sleep with other medications. For example, Tylenol PM includes diphenhydramine to help you sleep, and also acetaminophen, a medication prescribed for pain relief. If you are taking other medications, you should consult with the pharmacist to make sure occasional sleep aids are safe.

Dietary supplements

Melatonin

Melatonin is a hormone that your body releases naturally when it’s time to sleep. Taking melatonin triggers this response and helps your body relax. Some have reported side effects including headaches and confusion, but the supplement is generally very safe and can be effective in adjusting the timing of your sleep phase.

Chamomile and Valerian root

If you’re a lover of teas, then you know all about chamomile. It has been used for centuries to help people sleep and comes with very little risk. Similarly, Valerian root is a natural supplement that can be effective and very low- risk for side effects. Allergies exist for both, so take caution if you are trying these for the first time.

Saffron

“Studies have shown saffron also has the ability to relax and soothe us into more restful sleep,” said Dr. Patel. “The supplement may also have positive effects on pain relief and emotions.”

Risks for dietary supplements

Melatonin, chamomile, Valerian root, saffron and other dietary supplements are generally safe options to help you fall asleep. A word of caution however – the FDA doesn’t regulate dietary supplements. Which means there’s no guarantee the package contains what the manufacturer claims.

Long-term risks of over-the-counter sleep aids

“All of the sleep aids can be associated with daytime grogginess, and although addiction is not common, the efficacy of the drugs can wear off as your body grows a tolerance,” said Dr. Patel. While most won’t find themselves addicted to sleep aids, they may find that higher doses may be required to get the same effect. Dr. Patel warned against exceeding the recommended dosage, even if you still can’t fall asleep.

Dangers of prescription sleep aids

Prescription sleep aids are typically classified as sedative hypnotics. They are much stronger than OTC options and come with serious side effects including dizziness, nausea, hallucinations, depression and more. Studies have also found links to increased heart risk among other concerns.

Still can’t sleep?

If you feel the need to use a sleep aid for more than one week or if you are escalating your dosage, chances are good that something bigger is affecting your sleep.

“There may be underlying issues that can be easily addressed,” commented Dr. Patel, “such as sleep apnea (stopping breathing during sleep), poor sleep-related behaviors (such as excessive use of electronics), stress or anxiety.” Schedule a meeting with a sleep specialist to learn the root causes behind your trouble sleeping. Reliance on sleep aids can only last for so long. Sometimes a sleep medicine physician may need to perform a sleep study which allows for a thorough evaluation of brain waves, movements and breathing during sleep.

To determine your risk for sleep apnea and if seeing a sleep specialist is right for you, take our free sleep assessment.  

If you are struggling to sleep, you can learn more by reading these similar articles.

Join the Conversation

The Lowdown on Over-the-Counter Sleep Aids

Many people with insomnia first turn to over-the-counter (OTC) methods to help them sleep better: alcohol (not a good remedy since it worsens sleep quality), relaxation strategies, proper sleep hygiene, and OTC medications. Although OTCs may be helpful for the occasional sleepless night, they are not ideal treatments for those with chronic insomnia (e.g. those who experience sleep loss on a regular basis for as few as 2 weeks).

Just because something is sold OTC doesn’t mean it is without side effects. In addition, many OTCs can have negative interactions with other medications you may currently be taking. Below, I’ll list the most commonly taken OTCs and discuss the pros/cons with their use. Look at the active ingredient label on the OTCs to see if they contain any of the ones listed below.

1. Diphenhydramine (Nyquil ZZZ, Tylenol PM, Advil PM, Benadryl, Unisom Sleep): Diphenhydramine is a sedating antihistamine that creates drowsiness for some who take it. It may be helpful for occasional bouts of insomnia, but the biggest concern with taking it regularly (two or more weeks of regular use) it that tolerance can develop to the medication and any sedating effects tend to wear off. As a result, a psychological dependence may be formed for the medication (you think you need it, but most often the drowsy effects from the medication don’t really happen anymore). You also might start to take more of the medication to experience the same sleep-inducing effects. In addition, patients often report feeling drowsy and drained in the morning. Side effects commonly include dizziness, feeling “off” the next day, grogginess, dry mouth and memory problems.

2. Melatonin: Melatonin is a natural hormone produced by the pineal gland in the brain. Commonly referred to as the “hormone of darkness,” melatonin is produced in our brain when the sun goes down, therefore inducing sleepiness within a few hours. When we wake up in the morning and are exposed to light, melatonin production is stopped. Studies generally do not support the effectiveness of melatonin (typically between 3mg and 10mg) as a treatment for chronic insomnia. In my clinical practice, I’ve come across a limited few patients who do find it helpful, but I’d say that this has definitely been the minority. Further, melatonin is not currently regulated by the FDA. The formulations and potencies can actually vary from bottle to bottle without regulation. Side effects may include daytime sleepiness, headaches, confusion, sleepwalking, nightmares and nausea. It may also interact negatively with certain medications (diabetes medications, immunosuppressants, birth control pills, blood thinners).

When taken in very low dosages (0.5mg-3mg), melatonin has been shown to be very effective for those with circadian rhythm disorders such as jet lag and delayed sleep phase disorder. If you suffer from a circadian rhythm issue, talk with a sleep specialist to discuss the proper time to take melatonin (taking it just before bed isn’t advised for this population).

3. Doxylamine (Unisom Sleep Tabs): Another sleep-inducing OTC medication, its side effect profile is similar to that of diphenhydramine (discussed above).

4. Valerian: Limited research has shown some sleep benefits in taking valerian, and it might be useful for those who have occasional sleepless nights. Just like with melatonin, it is not regulated by the FDA and the potency can vary significantly between manufacturers. Research is rather new in this field and, though some suggest it as a possible treatment for insomnia, there’s not enough positive study support to make it a standard recommendation in the field. Side effects typically include excitability, nausea, uneasiness and headache.

If you are considering taking an OTC sleep aid, talk with your doctor to figure out the best plan to treat your insomnia. OTCs might be useful for very occasional bouts of insomnia, but other treatments such as cognitive behavior therapy for insomnia or prescription sleep aids may be more appropriate given your personal medical and psychiatric history. If you already have been taking OTCs on a regular basis for over 2 weeks, definitely discuss other treatment options with your doctor. Don’t mix OTCs with alcohol and be cautious of driving or operating any heavy machinery if you feel groggy as a side effect. Finally, if you are struggling with obtaining a good night’s sleep, talk with your doctor about getting a referral to a sleep specialist. Many good treatments are available for sleep disorders, and you shouldn’t suffer in silence.

Trouble sleeping? Experts say skip antihistamines

For people who take an antihistamine such as Benadryl for a cold or allergies, drowsiness is often a welcome side effect. But a Baylor College of Medicine sleep expert cautions against turning to this type of medication as a sleep aid.

“Many allergy sufferers know that antihistamines work for their symptoms but also make them sleepy. People sometimes turn to these medications to help them sleep, even when they’re not sick. But the use of medication to force children or adults to sleep is generally not the best idea,” said Dr. Philip Alapat, assistant professor of medicine.

Antihistamines have side effects that include altered mental state, urinary retention and dry mouth. While these side effects are generally mild and well tolerated in young patients without other medical problems, they can pose a risk, especially for the elderly.

“Use of antihistamines can lead to sleep walking and other parasomnias. That can definitely occur with Benadryl just as with other hypnotic agents like Ambien,” Alapat said.

While antihistamines may help you to fall asleep, overall sleep quality is usually not very good, he said. Sometimes, they even have the opposite affect and cause hyperactivity, especially in children.

“Using Benadryl or any antihistamine for sleep has no long term benefit,” Alapat said. “Most people develop a tolerance very quickly.”

Many over-the-counter sleep aids are simply antihistaminic drugs repackaged and labeled as something to help you achieve sleep, he cautioned.

Alapat recommends that people who suffer from long-term insomnia visit a physician or sleep disorders specialist to address the problem, which could result from medical issues such as obstructive sleep apnea, depression or circadian rhythm disorders.

“For many people, insomnia is short-term due to a stressful event or family problems. In this context, for a brief period it’s not unreasonable to consider pharmacological agents to help you get to sleep but even in this situation people should consult a physician to determine what medication might work best,” Alapat said.

Saying Goodnight to Insomnia

​Most of us have had a sleepless night or two. It’s part of life. But when a night of tossing and turning becomes a chronic problem, it may be time to dig a little deeper into what’s causing you to count sheep.

A first step to sweet dreams is to make sure you have good sleep hygiene habits and an environment conducive to a restful slumber, such as a dark, quiet room with no technology, i. e. a TV or laptop. If you continue to have sleep problems, consider seeing a physician to rule out any underlying health issue.

“Chronic insomnia is often secondary to another health condition like depression, a thyroid problem, chronic pain or cancer,” said
Kelly Lee, PharmD, associate professor of clinical pharmacy at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences. “By identifying and treating the primary health issue, the insomnia may resolve itself.”

There are individuals, however, who can still benefit from a doctor-prescribed sleep aid.

Lee discussed the general categories of sleep medications and recommends taking these them on an empty stomach to improve absorption and avoid delayed effect.  

Benzodiazepines – diazepam (Valium) and alprazolam (Xanax)

These medications non-selectively target the brain’s GABA receptors, reducing neuronal excitability, causing sedation. But they are not the preferred sleep aid anymore, particularly for older adults.

“They have lots of side effects and may cause dependence,” Lee said. “I personally no longer recommend them for my patients.”

These side effects include morning drowsiness, a drugged feeling or dizziness that can predispose older adults to life-altering falls.

Non-benzodiazepine hypnotics – eszopiclone (Lunesta), zolpidem (Ambien) and zaleplon (Sonata)

Also known as Z Drugs, the Food and Drug Administration (FDA) considers this category of medication to have the most evidence of helping chronic insomnia.

Unlike their predecessors, Z Drugs target a specific part of the GABA receptor. They can still cause “a hangover effect” and their use may lead to dependence.

Sonata is particularly helpful in inducing sleep, said Lee, but is not as effective in maintaining it. Ambien and Lunesta are effective at both, but Ambien, in particular, has been associated with rare but serious side effects, including doing activities while not being fully awake and not remembering them the next day.

Antihistamines – diphenhydramine (Benadryl and Unisom)

Antihistamines are commonly found in over-the-counter sleep aids, but are not recommended for sustained or frequent use, Lee said. They have a high tolerance threshold and may begin to lose effectiveness after as few as three to five doses. They also cause “morning fog.”

“These drugs are good at treating allergies, but they are not as effective in treating chronic insomnia,” Lee said.

Melatonin – Over-the-counter supplement and Ramelteon

Melatonin is a naturally occurring compound in the brain that plays a role in maintaining the circadian rhythm that promotes the normal sleep-wake cycle. Melatonin, sold over-the-counter as a supplement, as well as the prescription melatonin receptor agonist Ramelteon, alter a person’s circadian clock, which is particularly helpful for jet lag or shift work.

Orexin receptor agonists – suvorexant (Belsomra)

Orexin is a hormone that regulates wakefulness. The discovery that narcolepsy is caused by the loss of orexin-containing neurons led to the development of a new class of sleep aid. Since the chemical plays a role in keeping people awake and alert, a medication that blocks its action has the potential to promote sleep. The first drug on the market to target orexin’s role in wakefulness is suvorexant, approved by the FDA in 2014.

“We know less about suvorexant because it is such a new drug,” Lee said. “We will have to see if it offers any benefit over currently available drugs, but the cost will be an issue since there are no generics available.”

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This document, provided by Lexicomp ^® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Ambien; Ambien CR; Edluar; Intermezzo [DSC]; Zolpimist

Trade names: Canada

APO-Zolpidem ODT; MINT-Zolpidem ODT; PMS-Zolpidem ODT; Sublinox

Warning

• Some people who have taken this drug have performed activities such as sleepwalking, dream driving, cooking and eating, having sex or other activities without waking up completely.In rare cases, this has resulted in serious injury or death. In most cases, these persons did not remember that they had performed these actions. If you experience the above effects, stop taking this drug and tell your doctor immediately.

What is this drug used for?

• Used to treat sleep disorders.

What should I tell my doctor BEFORE taking this drug?

• If you are allergic to this drug, any of its ingredients, other drugs, foods or substances.Tell your doctor about your allergy and how it manifested itself.
• If you have liver disease.
• If you are taking medication or natural medicines as sleeping pills. There are many drugs that are used for sleep disorders. If in doubt, consult your doctor or pharmacist.
• If you have taken this or a similar drug in the past and performed any task or activity without waking up completely.
• If you are taking any of these medicines: rifampin or St. John’s wort.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking.Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

All forms of issue:

• Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• If sleeping pills are used each night for more than a few weeks, their effectiveness may be reduced.The so-called drug tolerance develops. Do not take sleeping pills for an extended period of time. If you have long-term insomnia, see your doctor.
• Long-term or regular use of this drug can lead to dependence. Sudden discontinuation of this drug may result in so-called “withdrawal” symptoms. Talk to your doctor before lowering the dose or stopping this drug.Follow your doctor’s instructions. If you experience any side effects, consult your doctor.
• Don’t take sleep breaks.
• To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position. Use caution when going up and down stairs.
• Avoid drinking alcohol while taking this drug. Do not use this drug if you drank alcohol that evening or before bed.
• Consult your doctor before using marijuana, other forms of cannabis, prescription or over-the-counter drugs that may slow you down.
• If you have phenylketonuria, talk to your doctor. Some foods contain phenylalanine.
• This drug may cause drowsiness or impair alertness. This can lead to falls and injuries, which can be very serious. Very severe injuries have been reported, such as a hip fracture and cerebral hemorrhage.Consult your doctor.
• If you are a woman, use this medication with caution. You may have more side effects.
• If you are 60 years of age or older, use this drug with caution. You may have more side effects.
• This drug is not approved for use in children. Children may be at increased risk of developing side effects such as dizziness and hallucinations. However, your child’s doctor may decide that the benefits of using this drug outweigh the associated risks.Talk with your doctor if you have any questions about how your child is using this drug.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.
• Taking this drug during the third trimester of pregnancy may cause some health problems in the newborn. Consult your doctor.

Extended release tablets:

• Your attentiveness may be reduced.On the day of taking the drug, stop driving vehicles, as well as other activities or activities that require increased attention.

All other dosage forms:

• Avoid driving or other activities or work requiring extra attention after taking this drug. You may feel drowsy the day after taking this drug. Avoid these activities or types of work until you are completely awake.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can have serious and sometimes deadly side effects. Call your healthcare professional or get medical attention right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

• Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
• The appearance or aggravation of behavioral or emotional disorders such as depression or suicidal thoughts.
• Hallucinations (a person sees or hears something that is not in reality).
• Confusion of consciousness.
• Lack of clarity of thinking.
• Difficulty, slow or shallow breathing.
• Balance change.
• Change of vision.
• Violation or loss of memory.
• A very severe reaction called angioedema has occurred with this drug.Sometimes this reaction can be life-threatening. Symptoms may include swelling of the hands, face, lips, eyelids, tongue, or throat, difficulty breathing or swallowing, or uncharacteristic hoarseness. Seek medical attention immediately if any of these symptoms occur.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects.Call your doctor or get medical help if these or any other side effects bother you or do not go away:

• Feeling dizzy, tired, or weak.
• Sleepiness the next day.
• Headache.
• Nausea.
• Diarrhea.

This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor.Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you.Follow all instructions strictly.

All forms of issue:

• If you still have sleep disturbances after 7-10 days, see your doctor.
• Take this drug before bed.
• Take this drug only 1 time per night.
• Take this medicine on an empty stomach.
• Do not take with or immediately after meals.

Pills:

• Take this medication right before you go to bed.
• Do not take this drug if you cannot get enough sleep at night (for at least 7-8 hours) before you need to be active again.

Extended release tablets:

• Take this medication right before you go to bed.
• Swallow whole. Do not chew, break, or crush.
• Do not take this drug if you cannot get enough sleep at night (for at least 7-8 hours) before you need to be active again.

Spray:

• Take this medication right before you go to bed.
• Inject into mouth over tongue.
• Prepare nebulizer before first use.
• Test pump dry with 5 sprays.
• If you have not used an aerosol for more than 14 days, test the pump dry with 1 spray or until you see small droplets of mist.
• Do not take this drug if you cannot get enough sleep at night (for at least 7-8 hours) before you need to be active again.

Sublingual lozenges (sublingual tablets):

• Do not touch the preparation with wet hands.
• Place under the tongue and allow to dissolve completely. Do not chew, suck, or swallow the tablet.
• Do not eat, drink or smoke until the tablet has dissolved.

Edluar:

• Take this medication right before you go to bed.
• Do not take this drug if you cannot get enough sleep at night (for at least 7-8 hours) before you need to be active again.

Intermezzo ^® :

• Take only as needed if you wake up in the middle of the night and cannot go back to sleep. Take a dose only if there is at least 4 hours before waking up. Do not exceed 1 dose per night.
• Keep only 1 packet of this drug near the bed.Store all other packages elsewhere. Do not remove the drug from the bag until you are ready to take a dose. Leave the empty bag in a visible place after taking the drug. This will serve as a reminder that you have already taken your dose.

What should I do if a dose of a drug is missed?

All preparations except Intermezzo:

• If you are taking this medication regularly, take the missed dose as soon as you can.
• If, after taking the missed dose, you cannot get enough sleep (for at least 7 hours), skip the missed dose and then return to your usual dosing schedule.
• Do not take 2 doses at the same time or an additional dose.
• Do not exceed 1 dose of this drug in one day.
• In most cases, this drug is used as needed. Do not take this medicine more often than prescribed by your doctor.

Intermezzo ^® :

• If you are taking this medication regularly, take the missed dose as soon as you can.
• If, after taking the missed dose, you are unable to sleep for at least 4 hours, do not take the missed dose and return to your normal dosage schedule.
• Do not take 2 doses at the same time or an additional dose.
• Do not exceed 1 dose of this drug in one day.
• In most cases, this drug is used as needed. Do not take this medicine more often than prescribed by your doctor.

How do I store and / or discard this drug?

All forms of issue:

• Store at room temperature in a dry place.Do not store in the bathroom.
• Store this medication in a protected place, out of the reach of children, and out of the reach of other people. A box or room, which is locked with a key, can act as a protected storage location for the drug. Keep all medicines out of the reach of pets.
• Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so.If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

Spray:

• Store upright with cap closed.
• Do not freeze.
• Discard after the specified number of sprays, even if you think there is still some drug left in the bottle.

General information on medicinal products

• If your health does not improve or even worsens, see your doctor.
• You should not give your medicine to anyone and take other people’s medicines.
• Some medicines may have different patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• A separate patient instruction sheet is attached to the product. Please read this information carefully. Reread it every time you replenish your supply.If you have questions about this drug, talk with your doctor, pharmacist, or other healthcare professional.
• If you think there has been an overdose of a drug, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Use of information by consumer and limitation of liability

This information should not be used to make decisions about taking this or any other drug.Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are suitable for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient. Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug.This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. Check with your doctor for complete information on the possible risks and benefits of taking this drug. Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

Copyright

© UpToDate, Inc.and its affiliates and / or licensors, 2021. All rights reserved.

90,000 Sleep Medications: OTC Options | Sleep Fund

Medical Disclaimer: The content on this page should not be taken as medical advice or used as a recommendation for any specific medications. Always check with your doctor before taking any new medications or changing your current dosage.

Many people take sleeping pills to help them fall asleep faster and get enough rest. Some sleeping pills, such as orexin receptor antagonists and benzodiazepines, require a doctor’s prescription. Other types of sleeping pills are available over the counter and can be used to treat insomnia and other sleep problems, but you should still exercise caution and talk to your doctor about risk factors, side effects, and other potential concerns before taking these medications for the first time. …

What OTC sleeping pills are available?

Although you can choose from dozens of different brands, most OTC sleeping pills fall into one of the following categories based on their chemical composition. Always check with your doctor before taking sleeping pills, whether or not a prescription is required.

Melatonin

Melatonin is a naturally occurring hormone produced by the pineal gland of the brain.During the day, the retina senses the presence of natural light and signals the brain to release hormones, such as cortisol, that induce feelings of wakefulness and wakefulness. When daylight dims in the evening, the pineal gland receives signals to release melatonin, which makes you feel tired and relaxed.

Certain factors can interfere with or decrease melatonin production, such as exposure to light in the evening, which essentially confuses the brain into thinking you should be awake.To increase melatonin levels, some people take melatonin supplements. These supplements can be made from animals, microorganisms, or, more commonly, synthetic components.

Melatonin may be recommended or prescribed under certain conditions. These include disturbances in the circadian rhythm of sleep that lower melatonin levels, such as delayed sleep-wake sleep or shift work disturbances, and some sleep disturbances in children. Melatonin may also improve symptoms in jet lag travelers.

The US Food and Drug Administration (FDA) classifies melatonin as a dietary supplement and does not regulate it as strictly as other types of drugs. Doctors say melatonin can cause allergies in some people. People with epilepsy and those taking blood-thinning medications should also be under medical supervision while taking melatonin to avoid potentially dangerous interactions. Get the latest sleep information from our newsletterYour email address will only be used to receive thesleepjudge newsletter.com.
More information can be found in our privacy policy.

Diphenhydramine

Diphenhydramine is an FDA-approved antihistamine commonly sold under the brand name Benadryl. It can be found in a wide variety of over-the-counter brand name drugs. pain relievers or antipyretics, including Advil PM, Excedrin PM, Nytol, Tylenol PM, and ZzzQuil.

Medicines with diphenhydramine may be recommended or prescribed for episodic bouts of drowsiness.

The effectiveness of diphenhydramine as a sleeping pill is questionable. In some studies, participants were given the recommended dose of 50 mg, and the results show that improvements in sleep are limited at best. At the same time, taking diphenhydramine at night was associated with psychomotor disturbances and decreased wakefulness the next day.

Several studies have shown that relatively large numbers of older people can chronically take drugs with diphenhydramine for the treatment of insomnia or personal care.Older adults are at a higher risk of insufficient or poorer sleep quality due to adverse health conditions such as hypertension, diabetes, heart disease, and stroke. Seniors in the United States account for approximately 35% of OTC drugs, and 12% of adults age 65 and older take over-the-counter sleeping pills.

Continuous use of these drugs can be problematic for the elderly because our metabolism slows down with age, which increases the drug’s half-life and prolongs its effect.This can lead to “residual sedation” if these hypnotics are taken in the evening.

Adolescents and young adults should also exercise caution when taking diphenhydramine. The FDA warns that doses of diphenhydramine in excess of the recommended dosages can lead to serious medical problems, including seizures, heart attack, coma, and death. In recent years, many young people have been hospitalized after taking excessive amounts of diphenhydramine as part of the Benadryl Challenge promoted through social media platforms.

Doxylamine

Like diphenhydramine, doxylamine, also known as doxylamine succinate, is a first-generation sedative antihistamine. Doxylamine can serve as a short-term treatment for insomnia or be used with decongestants to relieve cold symptoms such as sneezing or nasal congestion. It is marketed under brand names such as Unisom SleepTabs, Medi-Sleep, and Good Sense Sleep Aid, and may also be the active ingredient in pain relievers and antipyretic drugs.

If you are taking doxylamine for insomnia and symptoms persist for more than two weeks, you should see your doctor about other treatment options. Likewise, doxylamine for suppressing coughs and colds should not be taken for more than seven days unless symptoms go away. To date, 31 major drug interactions have been identified with doxylamine, including aspirin and acetaminophen.

As with diphenhydramine, studies have shown that older people often take these drugs chronically.This can lead to health problems, especially if the person also drinks alcohol regularly.

Valerian

Valerian is an herb sold and sold as a dietary supplement called Valerian Root and is often found in mild sedatives used to treat insomnia and anxiety. Although the functionality of valerian is not fully understood, researchers believe that it interacts with the receptors for GABA, serotonin, and adenosine. So far, the evidence that valerian is an effective remedy for insomnia is inconclusive.

Because valerian is a dietary supplement, it is not subject to FDA evaluations and approvals at the same level as other types of sleeping pills. As a result, the composition of valerian root tablets may vary by brand. High doses of valerian at bedtime have been linked to morning sleepiness, but the 600 mg standard dose does not appear to cause problems with reaction time, alertness, or concentration.

The effects of valerian on the unborn fetus and infants require further study, so pregnant women or nursing mothers should not take valerian unless they are under medical supervision.The same is with children under 3 years old. In addition, valerian can interact with other sleeping pills and cause additional drowsiness the next day.

Do over-the-counter sleeping pills cause side effects?

Although the side effects of OTC sleeping pills depend on certain factors, such as the dose and the person taking them, these medications are associated with the following:

Melatin

including acetaminophen

OTC sleeping pills	Possible side effects	Interactions with other drugs	394
Depression, dizziness, enuresis (bedwetting), excessive daytime sleepiness, headache and nausea	7 mild interactions
Diphenhydramine	Dizziness, lack of coordination, epigastric pain	and induration
Doxylamine	Dizziness, drowsiness, thickened mucus in the nose or throat, and dry mouth, throat and nose	31 major interactions, including acetaminophen and aspirin
Ba lerian	Headache, indigestion, cognitive dysfunction, dry mouth, feeling agitated or anxious, strange dreams and daytime sleepiness	3 major interactions including sodium oxybate and buprenorphine

Those with insomnia and other problems with sleep can potentially benefit from taking one of these medications.However, as with other medications, you should exercise caution and talk to your doctor before taking any over-the-counter sleeping pills. Your doctor can help you understand possible side effects and drug interactions, and alternative treatment options that may help you.

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  +8 sources

  1. 1. Aulinas, A. (2019).Physiology of the pineal gland and melatonin. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK550972/
  2. two. National Center for Complementary and Integrated Health. (2019, October). Melatonin: what you need to know. Retrieved November 30, 2020, from https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know
  3. 3. Sadegniat-Hagigi, K., Aminian, O. , Puryagub, G., & Yazdi, Z. (2008). Efficacy and hypnotic effects of melatonin in shift nurses: a double-blind, placebo-controlled, crossover trial.Journal of Circadian Rhythms, 6, 10. Retrieved from https://doi.org/10.1186/1740-3391-6-10
  4. Four. Albert, S.M., Roth, T., Toscani, M., Vitiello, M.V., & Zee, P. (2017). Sleep health and proper use of over-the-counter sleeping pills in the elderly – recommendations from the Gerontological Society of America Working Group. Gerontologist, 57 (2), 163-170. Retrieved from https://doi.org/10.1093/geront/gnv139
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The best sleeping pills: types and side effects – Medical

If you buy something from the link on this page, we may earn a small commission. How it works: Many people take sleeping pills to get much needed rest.

Contents

If you buy something from the link on this page, we may earn a small commission.How it works.

Many people take sleeping pills to get much needed rest.

Sleeping pills can be sedatives or hypnotics and come in many forms. People can choose natural, prescription or over-the-counter pills.

In this article, we will describe the types of sleeping pills, their use and safety profiles.

For more fact-based insights into the exciting world of sleep, visit our dedicated center.

Which sleeping pill is right for me?

Many people may not need sleeping pills.

By practicing sleep hygiene, exercising and avoiding alcohol and nicotine, a person can often improve their sleep cycle and prevent insomnia.

Insomnia is associated with problems falling asleep or sleeping. People with insomnia may wake up too early or may not feel rested upon waking up.

If lifestyle changes do not help, such as severe insomnia, sleeping pills may be a good short-term solution.

Avoid taking sleeping pills for a long time, as this can worsen insomnia, especially if the person stops taking the pill.

The range of sleeping pills includes over-the-counter (OTC) supplements and prescription drugs. Anyone with insomnia should consult with their doctor about the best approach.

Below are some of the most effective sleeping pills.

Melatonin

When it gets dark outside, the brain produces the hormone melatonin.This regulates the sleep-wake cycle, signaling the body to sleep.

The brain produces less melatonin in the light and more in the dark, such as in winter. Age also plays a role – the older a person gets, the less melatonin he produces.

Many sleeping pills contain melatonin. They tend to be most effective for people with circadian rhythm sleep disorders that are associated with sleep or wake timing problems.

Melatonin can be especially beneficial for people:

• experiencing jet lag
• trouble falling asleep at night
• coping with shift work

In recent years, manufacturers have been selling snacks and drinks containing melatonin as “relaxing” foods.However, doctors do not know if they are effective.

Melatonin supplements are available over the counter at pharmacies, supermarkets and online stores. The tablets are usually available in doses of 1-5 milligrams (mg) and should be taken at bedtime.

Limited evidence suggests that melatonin can treat insomnia. However, while some results have been mixed, most studies show that it can reduce the amount of time it takes to fall asleep, including a 2017 meta-analysis published in the journal. Sleep Medicine Reviews .

Sedative antihistamines

Sedative antihistamines can help people who have trouble falling asleep or sleeping.

Some OTC antihistamines that people commonly use to treat allergies can cause drowsiness.

Although not all antihistamines have this effect, people sometimes use first generation antihistamines or sedative antihistamines to improve sleep or relieve tension and anxiety.

Sedative antihistamines include:

• diphenhydramine, active ingredient Benadryl
• doxylamine, active ingredient Unisom
• cyclizine, active ingredient maresin

Second generation antihistamines are less likely to cause drowsiness. People use them to treat long-term allergy symptoms and they are ineffective as sleeping pills.

Non-sedating antihistamines include:

• cetirizine, active ingredient Zyrtec
• loratadine, active ingredient Claritin
• fexofenadine, active ingredient allegra

A doctor may recommend a short-term solution, but only an antihistamine.Although they are not addictive, the body quickly gets used to them, so they become less effective over time.

Valerian Root

Valerian is a plant. The healing properties of the root have been used by people since the times of Ancient Greece and Rome.

Valerian root is a common ingredient in herbal supplements that people use to improve sleep, relieve anxiety, and support relaxation.

Supplements come in many forms such as teas, liquids and capsules.

Several clinical studies show that taking valerian can improve sleep quality in people with insomnia. However, there is insufficient data to confirm whether valerian root is an effective hypnotic.

Valerian root sleep aids are available in pharmacies, health food stores and online stores.

Sleeping pills

Sleeping pills are a group of prescription-only sleeping pills.

A doctor may prescribe sleeping pills to treat a range of sleep disorders, including insomnia.These medications can also treat movement disorders that interfere with sleep, such as restless legs syndrome (RLS) and periodic limb movement disorder.

The most common sleeping pills are:

• zolpidem
• zaleplon
• esopiclone
• Ramelteon

Doctors usually prescribe sleeping pills only for prolonged and unpleasant insomnia, as these drugs can have side effects.

Another class of sedatives and hypnotics called benzodiazepines can also treat insomnia.These medications include:

• alprazolam
• diazepam
• lorazepam

Before prescribing a benzodiazepine, your doctor will usually recommend sleeping pills first. This is due to concerns about benzodiazepine dependence and its more serious side effects.

When to use sleeping pills

Always follow the directions for over-the-counter sleeping pills, including valerian products and antihistamines containing diphenhydramine or doxylamine.

The best time to take melatonin will depend on the nature of your sleep problem.

Sleeping pills for insomnia

A person with insomnia should take sleeping pills just before bed or before bed.

Sleeping pills for jet lag

If you are struggling with jet lag, take melatonin a few hours before your expected bedtime each day for the duration of your trip and for several days afterward. A dose of 0.5–5 mg is usually sufficient.

Sleeping pills for shift work

For people who work in shifts, taking 2-3 mg of melatonin at the end of the shift can help prepare the body for sleep.

Prescription sleeping pills

The correct dosage and frequency will largely depend on the person’s condition and the type of medication.

Always strictly follow your doctor’s instructions.

Side effects and risks

Sedatives, including antihistamines and sleeping pills, can make people feel tired, sleepy, or weak the next day.

In older people, taking these tablets may cause memory problems.

Certain sleeping pills, when taken to relieve insomnia, can make it difficult to fall asleep without them.

There is no evidence that the use of melatonin carries any serious risks. Researchers have yet to study the long-term effects.

Do not take sleeping pills before driving or using machinery.

For many people, the risks of using prescription sleeping pills outweigh the benefits.These medicines are only suitable for short term use. Most are addictive, which means they can be addictive and can also cause side effects.

Some side effects of prescription sleeping pills include:

• sleepiness or dizziness during the day
• confusion
• memory problems
• balance problems

On rare occasions, they can cause people to take actions, including driving, walking eating or making phone calls while sleeping.

Sleeping pills can also affect:

• remembering to take birth control pills regularly
• cimetidine for heartburn
• medicines for fungal infections

The safety profile of valerian root is still unclear. Possible side effects may include headaches, dizziness, itching, and stomach problems. Some people feel weak or sleepy in the morning after taking valerian root.

In addition, people who have taken valerian root for a long time and then suddenly stop taking it may experience withdrawal symptoms.People who stop taking benzodiazepines after a long period may experience similar symptoms.

Because the medical community is still uncertain about the effects, pregnant women and children under 3 years of age should not use valerian.

How to take sleeping pills safely

Always follow your doctor’s instructions for using sleeping pills.

The American Academy of Sleep Medicine recommends the following for people taking sleeping pills:

• Never take a pill without your doctor’s approval.
• Alcohol must not be consumed before using the medicine.
• Take your first dose if you have not scheduled anything the next morning.
• Do not drive or operate heavy machinery after taking sleeping pills.
• Seek medical attention immediately if any complications arise.

People taking prescription sleeping pills should contact their healthcare provider if they experience:

• confusion or extreme joy
• nervousness or anxiety
• focus problems
• dependence on sleep medication
• sleepiness in the morning

Older people should also talk to their doctors if they have problems with concentration, thinking or memory.

Summary

Sleeping aids can help a person get much needed rest, but most are only suitable for short-term use.

For example, sleeping pills may contain antihistamines or melatonin. Some tablets are only available with a doctor’s prescription.

The best type of pill will depend on the cause of the sleep disorder and the person’s sleep pattern. People with insomnia may benefit from one medication, while others with jet lag.

Take sleeping pills only when insomnia is more severe than recurrent insomnia.

The risks of prescription sleeping pills sometimes outweigh the benefits, and doctors generally recommend them only to people with severe sleep disturbances.

Question:

What are the best natural ways to improve sleep?

A:

Regular exercise is always beneficial for maintaining healthy sleep. The person should exercise several hours before bed.

Start relaxing about 1 hour before bed and keep the bedroom dark, quiet, and slightly cool to help you fall asleep quickly and feel comfortable. Maintaining the same sleep pattern, even on weekends, as much as possible, helps to synchronize the natural sleep cycle.

Avoiding caffeine, nicotine, and alcohol for a few hours before bed will always help you get adequate sleep.

Alan Carter, PharmD Answers provides the views of our medical experts.