Colin Snow
Sleep is essential for our health and well-being, but for those who struggle to sleep well, the option of sleeping pills may be considered. Sleeping pills are available both over the counter (OTC) and by prescription, with prescription pills being stronger and typically recommended for short-term relief. OTC sleeping pills are usually antihistamines, which can cause drowsiness and have side effects such as blurred vision, constipation, and confusion. Melatonin, valerian, and CBD are also available as OTC supplements, but they are not as strictly regulated as other medications. While sleeping pills can be helpful in the short term, they are not a cure for insomnia and can lead to dependence or addiction if used long-term. It is always best to consult a healthcare provider for advice and to explore non-drug treatments first.
| Characteristics | Values |
|---|---|
| Availability | Over-the-counter |
| Strength | Weaker than prescription sleeping pills |
| Usage | Short-term |
| Side effects | Constipation, diarrhoea, muscle weakness, digestive problems, blurred vision, confusion, drowsiness, dizziness, nausea, worsening snoring and sleep apnea |
| Addiction | Less likely to lead to addiction than prescription sleeping pills, but the body can develop a tolerance over time |
| Types | Antihistamines (e.g. diphenhydramine, doxylamine), melatonin, valerian, CBD |
| Risks | May cause daytime grogginess, not suitable for children, may interact with alcohol or other sleep medications |
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What You'll Learn
Side effects of sleeping pills
Sleeping pills can cause a range of side effects, from mild to severe. While over-the-counter sleeping pills are available, they can still cause side effects, and it is important to exercise caution when taking any sleep medicine. Prescription sleeping pills are stronger than over-the-counter ones, and healthcare providers generally recommend them only for short-term relief.
Some common side effects of sleeping pills include constipation, diarrhoea, muscle weakness, and digestive problems such as gas, heartburn, and nausea. Sleeping pills can also worsen snoring and sleep apnea, and long-term use can lead to dependence and rebound insomnia when you stop taking them. Additionally, approximately eight out of ten people experience a hangover effect the day after taking sleep medicine, feeling drowsy and experiencing muddled thinking, dizziness, and balance problems. These daytime effects can negatively impact your ability to drive, work, or perform daily tasks.
Sleeping pills can be especially risky for older adults, as they tend to stay in their system longer, increasing the likelihood of side effects such as confusion, memory issues, and balance problems, which can lead to falls and hip fractures. People aged 65 and older should typically try non-drug treatments first, as there may be safer ways to improve sleep without the risks associated with sleeping pills.
In rare cases, sleeping pills can cause more severe side effects such as burning or tingling sensations in the extremities, and they can interfere with normal breathing in people with certain chronic lung problems like asthma, emphysema, or chronic obstructive pulmonary disease (COPD). Benzodiazepines, a common type of prescription sleeping pill, can be addictive and lead to substance use disorders. An overdose of sleeping pills can be deadly, especially when combined with alcohol or other medications.
It is important to speak with a healthcare provider before taking any sleeping pills, whether over-the-counter or prescription, to ensure they are safe for you and do not interact with any other medications you may be taking.
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Safety concerns for older adults
Sleeping pills are available over the counter (OTC) as natural supplements or by prescription. Anyone over the age of 18 can purchase OTC sleep medications at drugstores or other retail locations without a prescription. However, it is important to exercise caution when taking sleeping pills, especially for older adults, due to the potential side effects and safety concerns.
Older adults should typically try non-drug treatments first as there may be safer ways to improve sleep. Sleeping pills can have special risks for this demographic, as they tend to stay in the body longer, leading to side effects such as confusion, memory issues, and balance problems. These issues can increase the risk of falls and hip fractures, which are particularly concerning for older individuals. Furthermore, the long-term safety of hypnotics is unclear, and most guidelines recommend short-term use for up to 5–6 weeks.
It is important to follow the usage instructions on the medication's label and the advice of a doctor or pharmacist. OTC sleep aids often contain antihistamines, which can cause drowsiness. While antihistamines are effective in treating allergies, their sedative effects may negatively impact daily functioning, causing dizziness, muddled thinking, and digestive problems. Additionally, mixing antihistamines with prescription sleep drugs can lead to central nervous system depression.
Sleeping pills can also cause a "hangover effect," with approximately 8 out of 10 people experiencing drowsiness, dizziness, and balance issues the day after taking them. This can impair driving ability and work performance, and the sedative effects may persist beyond the morning after taking the medication. Therefore, it is recommended to refrain from driving or operating heavy machinery until the full effects are understood.
Lastly, sleeping pills can be habit-forming, and there is a risk of dependence and addiction, especially with prescription sleeping pills. Healthcare providers typically prescribe sleeping pills for short-term relief, and it is important to follow the prescribed dosage to mitigate this risk.
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Natural alternatives
While over-the-counter (OTC) sleeping pills are readily available, they are not recommended for regular use due to potential side effects and the risk of dependency. Natural alternatives to OTC sleeping pills include:
- Valerian: Valerian root has been used as a natural sleep aid for centuries. It is available in various forms, including pills, teas, and other formulas. While research on its effectiveness is mixed, some evidence suggests that valerian can help people fall asleep faster and improve sleep quality. However, mild side effects such as headaches and weakness may occur.
- Lavender essential oil: Lavender is known for its calming and soothing properties. Incorporating lavender essential oil into your bedtime routine can be done in several ways, such as using lavender-infused lotions, adding bath salts to your evening bath, or spraying lavender-scented linen spray on your sheets and pillow.
- Melatonin: Melatonin is a hormone that regulates sleep timing. While it is available as a supplement, it is not intended to be a long-term sleep aid. Instead, it is useful for shifting your sleep schedule, such as when travelling across time zones.
In addition to these natural alternatives, developing good sleep habits, also known as "sleep hygiene," is crucial for improving sleep quality. This includes practices such as maintaining a consistent bedtime, keeping your bedroom temperature cool, and avoiding falling asleep with the television or radio on to prevent disturbances.
If you experience ongoing sleep difficulties, it is recommended to consult a healthcare professional or a sleep specialist. They can provide guidance on appropriate sleep aids or refer you for cognitive behavioural therapy to address insomnia and improve your sleep quality.
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Sleeping pills and pregnancy
Sleeping pills are available both over the counter and by prescription. Over-the-counter pills tend to be weaker than prescription pills, and most contain antihistamines. Prescription pills are only recommended for short-term relief due to the risk of dependence and addiction. Sleeping pills can cause side effects such as constipation, muscle weakness, digestive problems, and worsened snoring and sleep apnea.
Pregnant individuals are advised to consult a healthcare provider before taking any over-the-counter or prescription sleeping pills or supplements. Sleep disturbances are common during pregnancy, affecting 77% of pregnant individuals, with issues often peaking in the third trimester due to bodily discomforts such as frequent urination, nausea, and heartburn. While there are limited data regarding the reproductive safety of commonly prescribed sedative-hypnotic agents such as Ambien (zolpidem), Lunesta (eszopiclone), and Sonata (zalepion), these medications are generally avoided during pregnancy.
Safe sleep aids for pregnant individuals include antihistamines such as Benadryl (diphenhydramine) and Unisom Sleep Tabs (doxylamine), as well as melatonin and selective serotonin reuptake inhibitors (SSRIs). However, it is important to consult a healthcare provider before taking any of these medications. Treating any underlying disorders, such as depression or anxiety, may also improve sleep quality during pregnancy.
There are also non-pharmaceutical interventions that can help alleviate pregnancy-related insomnia. These include following sleep hygiene practices, such as sleeping on the left side, keeping the bedroom dark and quiet, establishing a regular bedtime routine, and eating and drinking mindfully. Additionally, decreasing caffeine consumption, limiting screen time before bed, taking warm baths, and listening to relaxing music can help improve sleep during pregnancy.
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Sleeping pills for children
Sleeping pills are medications that can help with sleep. They are available over the counter (OTC), as natural supplements, or by prescription. While prescription sleeping pills are stronger than over-the-counter ones, they are not recommended for long-term use due to the risk of dependence and addiction. Over-the-counter sleeping pills, on the other hand, are easily accessible and do not require a prescription. However, it is always advisable to consult a healthcare provider before taking them, as they can interfere with other medications or aggravate existing health conditions.
When it comes to children, the use of sleeping pills is a more complex issue. There are no prescription medications approved for insomnia in children, according to Judith Owens, a board-certified sleep medicine physician. Over-the-counter sleep aids, on the other hand, lack sufficient scientific evidence to support their use in children, according to Jennifer Martin, a psychologist and professor of medicine. Additionally, these medications are not strictly regulated, and their side effects in children are not fully understood.
Despite the lack of scientific evidence and potential risks, research presented at the AAP National Conference & Exhibition revealed that parents commonly use over-the-counter medications as sleep aids for their children. The most commonly used OTC drug to promote sleep in children is Benadryl, with 23.9% of parents reporting any use as a sleep aid. Other commonly used OTC drugs include cough syrup, NyQuil, Tylenol PM, Advil PM, ZzzQuil, and Unisom. However, it is important to note that the majority of parents who administered these drugs to their children did not do so under the recommendation or supervision of a pediatrician.
While melatonin is a natural hormone that plays a role in sleep regulation, its use as a sleep aid for children is controversial. Melatonin supplements are not regulated by the FDA, and their side effects in children are not fully understood. Some parents have reported symptoms like bedwetting, drowsiness, headaches, and agitation after their children took melatonin. Additionally, there is limited evidence to support melatonin's use in typically developing children, according to Owens.
In conclusion, while sleeping pills may be available over the counter for adults, their use in children is not recommended by experts. There is limited scientific evidence to support the effectiveness of over-the-counter sleep aids in children, and potential side effects and risks may outweigh the benefits. If your child is struggling with sleep issues, it is important to consult a healthcare professional for advice and explore other strategies to improve their sleep before considering sleep aids.
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Frequently asked questions
Yes, there are over-the-counter (OTC) sleeping pills available. These are usually antihistamines, such as diphenhydramine, and are best used in the short term.
Side effects of OTC sleeping pills can include constipation or diarrhoea, muscle weakness, digestive problems, and blurred vision. Approximately 8 out of 10 people experience a hangover effect the day after taking sleep medicine, which can negatively impact your ability to complete daily tasks.
Yes, melatonin, valerian, and CBD are natural alternatives to OTC sleeping pills. However, these supplements are not regulated by the Food and Drug Administration as strictly as other medications, so there is no way to know for sure if the pill contains what is stated on the label.
