Ashwin Lewis
Sleep aids are designed to help people with sleep disorders like insomnia fall asleep and stay asleep through the night. They are available over the counter (OTC) or by prescription. OTC sleep aids often contain antihistamines, which block histamines, the substances in the body that cause alertness. Prescription sleep aids, on the other hand, work in different ways depending on their chemical composition. For example, benzodiazepines work by stimulating GABA, a chemical in the brain that causes sedation and relaxation. While sleep aids can be useful in the short term, they are not meant for long-term use and can lead to dependency and addiction.
| Characteristics | Values |
|---|---|
| How sleep aids work | They have a sedative effect, making people feel sleepy and relaxed |
| Types of sleep aids | Prescription medications, over-the-counter drugs, and dietary supplements |
| Prescription sleep aids | Benzodiazepines, Z-drugs, selective GABA medicines, and melatonin |
| Over-the-counter sleep aids | Antihistamines, such as diphenhydramine |
| Dietary supplements | Melatonin, valerian, or kava |
| Side effects | Dizziness, fatigue, irritability, digestive problems, muscle weakness, dependency, and rebound insomnia |
| Recommendations | Short-term use is generally recommended to avoid side effects and dependency issues |
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What You'll Learn
Natural sleep aids
One well-known natural sleep aid is melatonin, a hormone that is naturally released in the brain a few hours before we start feeling sleepy. Melatonin supplements are available in pharmacies as unregulated over-the-counter pills. While they have been shown to enhance sleep, there are mixed reports about their effectiveness, with some people experiencing grogginess and others awakening in the middle of the night. Short-term use (three months or less) is considered safe, and experts suggest that fast-release melatonin may be more effective than slow-release formulas.
Magnesium is another natural sleep aid that has been the subject of research. It is believed to be important for fetal development and is generally considered safe for pregnant or nursing women when taken under the guidance of a healthcare professional. Valerian root is also a popular natural sleep aid that has been used for hundreds of years. It is thought to boost relaxation by increasing levels of GABA (gamma-aminobutyric acid), a brain chemical that promotes sleep. While it is considered safe for short-term use, some people may experience headaches and stomachaches as side effects.
Other natural sleep aids include chamomile tea, which has been used as a herbal remedy for centuries and is believed to have a calming effect. CBD products, derived from cannabis or hemp plants, have also been found to relieve anxiety and act as a natural sleep aid, particularly for those suffering from insomnia. Additionally, tart cherry juice may support melatonin production and promote a healthy sleep cycle. While there is limited scientific proof, warm milk is often recommended for those seeking a natural sleep aid without side effects or drug interactions. It is believed to contain chemicals that mimic the effects of tryptophan, a building block for serotonin, which plays a role in the sleep-wake transition.
It's important to remember that even natural sleep aids can have side effects and risks. Always consult a medical professional before taking any supplements, especially if you are pregnant, nursing, or have existing conditions or medications. Additionally, practice good sleep hygiene and maintain a consistent sleep routine to improve your sleep quality.
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Over-the-counter sleep aids
Over-the-counter (OTC) sleep aids are easily accessible without a prescription. They are often used to treat occasional sleeplessness, but they can also be used for long-term sleep problems. However, it is recommended to consult a healthcare provider before taking them as they can interfere with other medications or aggravate certain health conditions. OTC sleep aids are generally safe, but they can come with side effects and potential risks. For example, antihistamines, a common ingredient in OTC sleep aids, can cause side effects such as dry mouth, blurred vision, and fatigue, especially in older adults.
OTC sleep aids work by blocking certain brain chemicals, which can have a sedating effect. Antihistamines, such as diphenhydramine and doxylamine, are commonly found in OTC sleep aids because they can cause drowsiness. Diphenhydramine is a sedating antihistamine that is found in a wide range of non-prescription sleep and allergy medicines, such as Benadryl. Doxylamine, another sedating antihistamine, is available OTC in various forms, including tablets, capsules, oral liquids, and chewable tablets, and is sold under the brand Unisom SleepTabs.
Some people prefer natural remedies to help them sleep, such as melatonin, valerian root, or cannabidiol (CBD) supplements. Melatonin is a chemical naturally produced by the body to regulate sleep and wake cycles, and OTC melatonin is a synthetic version. Valerian root is said to help people fall asleep and reduce anxiety and stress. However, there is limited data on the effectiveness of herbal supplements, and the FDA does not regulate them, so there is no guarantee of their contents.
While OTC sleep aids can be convenient, they are not a cure for insomnia and should not replace good sleep habits. Most sleep problems can be corrected without medication, and healthcare providers typically recommend trying other methods first, such as cognitive behaviour therapy, limiting caffeine intake, creating a comfortable sleep environment, and maintaining a consistent bedtime routine.
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Prescription sleep aids
Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta), are another type of prescription sleep aid. While they can help induce sleep, they may also cause parasomnia, a disruptive sleep disorder where individuals may sleepwalk, eat, talk, or even drive without being fully awake. The majority of people do not remember performing these activities after they wake up. Z-drugs are generally preferred over benzodiazepines due to a lower risk of dependence.
Other prescription sleep aids include antidepressants or anti-anxiety medications, which can induce drowsiness as a side effect. Examples include mirtazepine (Remeron), trazodone, and quetiapine (Seroquel). Additionally, anti-Parkinsonian drugs, such as gabapentin enacarbil (Horizant) and pramipexole (Mirapex), may be prescribed to treat restless leg syndrome and periodic limb movement disorders.
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Side effects
Sleep aids can cause a range of side effects, with over-the-counter and prescription pills potentially leading to constipation, diarrhoea, muscle weakness, digestive problems, worsened snoring and sleep apnea, and a hangover effect the following day. Some sleep aids can also be habit-forming, leading to an increased risk of side effects and potential withdrawal symptoms if you stop taking them.
Prescription sleep aids, such as benzodiazepines, can cause dizziness, fatigue, irritability, and long-term side effects like depression, especially in patients with liver and kidney disease. Older adults are more susceptible to the side effects of sleep aids, with an increased risk of confusion, memory issues, and balance problems, which can lead to falls and hip fractures.
Natural sleep aids, such as melatonin and valerian, are also associated with side effects. Melatonin, for example, has been shown to lower sperm counts in mice, so men experiencing infertility should consult their doctor before taking it. Valerian has mild side effects, which may include headaches and weakness.
In addition to the specific side effects associated with different types of sleep aids, there are also general risks and negative effects associated with their use. Sleep aids can interfere with other health conditions, for example, worsening symptoms of depression. They can also lead to parasomnia, a disruptive sleep disorder where individuals may sleepwalk, eat, talk, or even drive while mostly asleep.
It is important to consult a healthcare professional before taking any sleep aid to ensure safe and appropriate use, and to discuss any potential side effects or risks.
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Addiction and withdrawal
Sleep aids can be highly addictive, and it is easy to become dependent on them—sometimes after only a few weeks of use. This is true of both over-the-counter and prescription sleep aids. The body can quickly become reliant on sleep aids, and quitting can be difficult because the user may experience withdrawal as their body tries to readjust.
Withdrawal symptoms can occur when a person abruptly stops using sleep aids. These symptoms can be both physical and psychological and vary from person to person. They can include trouble sleeping, restlessness, anxiety, shivering, circulation problems, dizziness, and fainting. In some cases, seizures can occur, which can be dangerous or even life-threatening. These symptoms are similar to the issues the sleep aid was originally meant to address, creating a vicious cycle where the user is compelled to take the sleep aid to relieve their symptoms.
To avoid such relapses, it is recommended that users gradually reduce their dosage over several weeks, with the guidance of a doctor, before stopping completely. This method, known as tapering, takes longer but results in less severe withdrawal symptoms. Medical detox is always the safest way to detox from sleep aids, as doctors can monitor the patient and address any potential health concerns.
Certain types of therapy can also help individuals sleep without medication. It is important to seek help if you are struggling to stop using sleep aids.
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Frequently asked questions
Sleep aids can be divided into three types: prescription medications, over-the-counter drugs, and dietary supplements.
Over-the-counter sleep aids often contain antihistamines, which can make you drowsy by blocking histamines, the substances in your body that cause alertness.
Melatonin, valerian, and kava are some natural sleep aids that can be purchased as dietary supplements. Melatonin is a hormone that influences when you fall asleep and wake up, while valerian has a calming effect on your nervous system.
Prescription sleep aids work in different ways depending on their chemical composition. Benzodiazepines, for example, stimulate the chemical GABA in the brain, leading to sedation, muscle relaxation, and reduced anxiety. Z-drugs, another class of prescription sleep aids, slow down activity in the brain to induce a sedative effect.
Sleep aids can cause various side effects, including daytime drowsiness, muscle weakness, and constipation. Natural sleep aids like melatonin may cause confusion or sleepiness during the day, and some people may experience parasomnia, or sleepwalking and sleep eating. It is important to discuss any concerns about side effects with your healthcare provider before taking sleep aids.
