Miya Pearson
Sleep is an essential part of a healthy lifestyle, but many people experience sleep difficulties. Sleep aids are easily accessible over the counter, but it is important to understand their efficacy and side effects. Sleep aids work in different ways, from stimulating chemicals in the brain to blocking histamines that cause alertness. Natural sleep aids, such as melatonin, valerian, and magnesium, are also available. However, sleep experts advise against using common over-the-counter antihistamine and analgesic sleep aids due to safety concerns and a lack of evidence of their effectiveness. Prescription sleep aids are stronger but are not intended for long-term use due to the risk of dependence and addiction.
| Characteristics | Values |
|---|---|
| Type | Over-the-counter (OTC) or prescription |
| Ingredients | Antihistamines, melatonin, valerian, etc. |
| Effectiveness | OTC sleep aids are easily accessible but may not be suitable for everyone. Check with your healthcare provider before taking them. |
| Side Effects | May cause drowsiness, dizziness, stomach upset, blurred vision, photosensitivity, etc. |
| Precautions | Do not drive or operate heavy machinery until you know how the sleep aid affects you. |
| Natural Alternatives | Warm milk, chamomile tea, tart cherry juice, exercise, etc. |
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What You'll Learn
Natural sleep aids, like melatonin and valerian
Melatonin is a natural hormone that helps regulate your sleep. Melatonin levels rise about two hours before bedtime, putting you into a state of quiet wakefulness that helps promote sleep. While most people's bodies produce enough melatonin for sleep on their own, melatonin supplements can help those with insomnia fall asleep faster and improve sleep quality. They may also have bigger benefits for those with delayed sleep phase syndrome. Melatonin supplements are generally safe and well-tolerated for short-term use, but it is recommended to consult a healthcare provider before long-term use. To improve the effectiveness of melatonin, it is recommended to limit screen time and exposure to blue light before bed, as this can neutralize its effects.
Valerian, an extract from the roots of the Valeriana officinalis flowering plant, has been widely used to treat sleeping disorders in Europe for decades and is becoming more popular in the United States. A systematic review of randomized, placebo-controlled trials found that valerian use almost doubled the chance of sleeping better compared to a placebo. It is relatively inexpensive and has no known side effects, making it a potentially important treatment alternative for insomnia.
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Prescription sleep aids
There are several different types of prescription sleeping pills, classified as sedative hypnotics. These medications work by acting on receptors in the brain to slow down the nervous system. For example, benzodiazepines stimulate a chemical in the brain called GABA, leading to sedation, muscle relaxation, and reduced anxiety. Z-drug sleep aids, such as zolpidem (Ambien) and eszopiclone (Lunesta), work by slowing down brain activity.
It is important to discuss prescription sleep aids with a healthcare provider to understand their possible side effects and risks. They should be evaluated for efficacy on a regular basis, and if you decide to stop taking the medication, this should be done gradually and under the guidance of a doctor.
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Over-the-counter sleep aids
Over-the-counter (OTC) sleep aids are easily accessible and can be purchased without a prescription. They often contain antihistamines, which treat allergies but can also cause drowsiness. Natural sleep aids, such as melatonin and valerian, are also available as OTC supplements. Melatonin is a hormone that promotes sleep, while valerian has a calming effect on the nervous system. However, it's important to consult with a healthcare provider before taking OTC sleep aids as they can interfere with other medications or health conditions.
OTC sleep aids come in various forms, including capsules, liquids, tablets, and chewable tablets. Common brand names include Benadryl, Nytol, and Unisom, which contain the active ingredient diphenhydramine. Diphenhydramine is an antihistamine that can help with allergies, colds, allergic reactions, and motion sickness, in addition to aiding sleep. It is important to note that diphenhydramine can cause side effects such as drowsiness, dizziness, and stomach upset, and it may affect alertness, coordination, and vision. Therefore, activities that require alertness or clear vision should be avoided until you know how diphenhydramine affects you.
While OTC sleep aids can be convenient, they are not intended for long-term use. Most prescription sleep aids are also meant for short-term relief, and it's important to evaluate their effectiveness and potential side effects with a doctor regularly. Additionally, as people age, their bodies may respond differently to medications, so it's crucial to review all medications with a doctor to ensure safe and appropriate use.
Natural sleep aids and home remedies offer alternative options for improving sleep. For example, drinking warm milk, chamomile tea, or tart cherry juice before bed is believed to promote sleep without causing side effects or drug interactions. Tart cherry juice, in particular, may support melatonin production and a healthy sleep cycle. Establishing good sleep habits, such as limiting exposure to light from smartphones or other devices before bed, is also important for improving sleep quality.
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Non-drug therapies, like cognitive behavioural therapy (CBT)
Non-drug therapies, such as cognitive behavioural therapy (CBT), can be effective in improving sleep. CBT-I, a form of CBT, is a successful treatment for insomnia. CBT-I involves changing behaviours and reframing anxious thoughts related to sleep. It combines cognitive therapy, behavioural interventions, and educational interventions. CBT-I can be delivered alongside the use of sleeping pills.
CBT-I guides patients through a series of changes in sleep-related behaviours. This includes identifying and eliminating habits that were developed to improve sleep but have become ineffective, as well as reducing sleep-related worry and other sources of heightened arousal. The therapist helps patients overcome obstacles to making changes in sleep-related behaviours, such as re-evaluating beliefs about sleep that may be causing unnecessary anxiety.
The core components of CBT-I are Sleep Restriction Therapy (SRT) and Stimulus Control Therapy (SCT). SRT involves cutting down on time spent awake in bed, leading to improved sleep efficiency. SCT strengthens the association between sleep cues (such as the bed, bedroom, and bedtime) and falling asleep easily, promoting better sleep. It involves avoiding any non-sleep-related activities in the bedroom and only lying in bed when feeling sleepy.
CBT-I is typically delivered over five to eight sessions, lasting 30 to 90 minutes each. The length of treatment depends on the patient's adherence and engagement with the assigned exercises. Research suggests that 70-80% of people with chronic insomnia who try CBT-I experience improved sleep, and these improvements tend to be long-lasting. However, it may take a few weeks for individuals with chronic insomnia to notice improvements, and some may feel more tired at the beginning of treatment.
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Side effects of sleep aids
Sleep aids can have both short-term and long-term side effects. Short-term use of sleep aids can cause drowsiness, dizziness, digestive problems, muscle weakness, and impaired focus the next day. Approximately 8 out of 10 people experience a hangover effect the day after taking sleep medicine.
Older adults are more susceptible to the side effects of sleep aids. The drugs can stay in their system longer, and the resulting drowsiness can last into the following day. Confusion, memory issues, and balance problems are also common side effects for older adults, increasing the risk of falls, broken hips, and car accidents.
Long-term use of sleep aids can lead to dependency, drug tolerance, and adverse effects on brain function. It can also change the structure of sleep and cause respiratory depression during sleep, which may lead to death. Additionally, sleep aids can worsen insomnia in the long term and lead to conditions such as depression, poor memory, brain degeneration, and Alzheimer's disease.
Abruptly discontinuing sleep aids can also result in rebound insomnia, which may feel more frustrating than the original insomnia. It can be accompanied by vivid dreams, nightmares, and anxiety. It is recommended to gradually reduce the dosage of sleep aids under the guidance of a healthcare provider to minimize withdrawal side effects.
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Frequently asked questions
Nighttime sleep aids are medications or supplements that can help you fall asleep and stay asleep. They can be bought over the counter or prescribed by a doctor.
Nighttime sleep aids work in different ways depending on the type of supplement or medication. Some cause drowsiness, while others silence the area of your brain that keeps you alert. Natural sleep aids like melatonin and valerian promote sleep by influencing when you fall asleep and wake up.
Yes, sleep aids can cause side effects such as confusion, sleepiness during the day, dizziness, and balance problems. Some people also experience parasomnia, where they walk or eat in their sleep.
Most prescription sleep aids are not intended for long-term use due to the risk of dependence and addiction. It is important to evaluate their efficacy and any side effects with your doctor on a regular basis.
