Can’t sleep? Non-prescription sleeping pills may be the ticket to dreamland, but beware. Some sleep medication for insomnia can cause a hangover effect the next day.
Shelves in drug, discount, and grocery stores are stocked with a dizzying array of insomnia aids these days. From sleeping pills to get-to-sleep hormones to herbal remedies, more and more over-the-counter (OTC) insomnia treatments are available for sleep-deprived customers. But do they work?
“Some products available without a prescription can be helpful for occasional insomnia, but there are downsides,” warns Paul Selecky, MD, medical director of the Hoag Sleep Disorders Center in Newport Beach, Calif.
Here’s what you should know before you reach for that bottle of sleeping pills or another sleep medication.
Insomnia Treatment: Over-the-Counter Sleeping Pills
You may be surprised by the ingredients in sleep medication readily available in stores:
- Antihistamines. The vast majority of OTC sleeping pills contain antihistamines. The reason: Besides fighting allergies, many antihistamines promote drowsiness and therefore sleep. Some of the more popular brands are Sominex, Unisom, Sleep-Eez, and Nytol. Most OTC insomnia treatments, whether pill, capsule, or gelcap, contain the antihistamine diphenhydramine (the key ingredient in Benadryl). A few others use doxylamine, another antihistamine, while some combine antihistamines with the pain reliever acetaminophen. For occasional insomnia, these OTC sleeping pills may be just the ticket to push you into dreamland. The problem is that their sedating effect may not end when you wake up. “They can cause drowsiness or a hangover effect that may last well into the next day,” explains Dr. Selecky. And if you take these insomnia treatments too frequently, they may cause forgetfulness, headaches, and dizziness. Because of their side effects, many doctors discourage using these sleep medications for anything other than occasional use.
- Pain relievers. For insomnia caused by minor pain, simply taking an OTC pain reliever may be all that’s needed to bring on sleep. Examples are ibuprofen (Advil, Motrin) and acetaminophen (Tylenol). These medications won’t cause next-day drowsiness. And as mentioned above, some of these pain relievers can also be purchased as a combination drug containing an antihistamine. These antihistamine-pain reliever combos usually have a slightly different brand name, such as Tylenol PM.
- Melatonin. Melatonin is a hormone that helps to regulate the body’s sleep-wake cycles and is available in a synthetic form as well as a supplement, but how well it works depends on your needs. “It seems to be most effective for insomnia related to disruption of circadian rhythms, as in jet lag or shift work, or for people who have low melatonin levels,” says Selecky. In one small Canadian study, taking melatonin for four weeks helped normalize circadian rhythms (natural body cycles related to the 24-hour day) and allowed insomniacs to fall sleep more quickly. Melatonin may also be effective for insomnia associated with attention deficit hyperactivity disorder (ADHD), according to a Duke University review of four clinical trials involving children ages 6 to 14. Those given melatonin doses ranging from 3 to 6 milligrams were more likely to be able to fall asleep and stay asleep without side effects. However, higher doses of this insomnia treatment in kids and adults can cause cognitive impairment, severe headaches, and nightmares.
If you’d prefer an alternative herbal aid, one of these may help:
- Valerian. This medicinal herb often consumed as a tea appears to help you fall asleep faster and may improve the quality of sleep. A 2008 study found that people who took valerian before bed spent more time in deep sleep than other people when their sleep was measured in a lab. “Valerian is probably less effective than antihistamine-type sleep medications, but the advantage is that side effects are minimal,” says Selecky. There’s usually no hangover effect. One downside: “Some people think valerian smells like dirty socks,” Selecky adds.
- Chamomile. Chamomile is a plant in the daisy family that’s been used for centuries to help gently bring on sleep. In fact, chamomile is so mild and safe that it’s often used to calm colicky babies. In one study, three to four ounces of herbal tea containing chamomile helped eliminate colic in almost 60 percent of colicky babies and bring on sleep. Rarely, chamomile can cause a rash or mild breathing difficulties in children or adults with allergies to ragweed or similar plants. There are no other known side effects.
Even with the wide variety of non-prescription sleep aids available, it’s best to consult your doctor before popping sleeping pills or sipping sleep-promoting tea. A physician may be able to recommend certain products or steer you away from those that may interact with other medications you’re taking.
And if you have long-term sleep problems, meaning that you have difficulty more than three nights per week, it’s especially important to consult your doctor. You may need prescription medication or behavioral therapy to bring on slumber.
By Jan SheehanMedically reviewed by Lindsey Marcellin, MD, MPH
DEC