Evie Summers
Sleep aids are a common solution for people experiencing insomnia or sleeplessness. They are easily accessible, with over-the-counter (OTC) options available for adults, and natural remedies such as melatonin and valerian supplements. However, it is important to exercise caution when considering sleep aids due to potential side effects and risks. Sleep aids should not be used long-term without medical advice, and it is recommended to consult a healthcare provider to ensure the benefits outweigh the risks and to rule out any underlying sleep disorders or medical conditions. While sleep aids can provide short-term relief, cognitive-behavioral therapy (CBT) and improving sleep habits are also recommended for long-term improvements to sleep quality.
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What You'll Learn
Side effects of sleep aids
Sleep aids can have both short-term and long-term side effects. Short-term use of sleep aids is generally considered acceptable, but long-term use should be avoided due to potential adverse health effects.
Common short-term side effects of sleep aids include drowsiness, dizziness, constipation or diarrhoea, muscle weakness, digestive problems, and impaired focus the next day. Approximately 8 out of 10 people experience a hangover effect the day after taking sleep medicine, which can negatively impact their ability to perform daily tasks. Sleep aids may also worsen snoring and sleep apnea.
Long-term use of sleep aids can lead to drug dependence, tolerance, and other side effects such as poor memory, brain degeneration, and a heightened risk of Alzheimer's disease. Sleep aids may also contribute to depression, especially in patients with liver and kidney disease. Additionally, older adults are more susceptible to health problems caused by sleep aids, including confusion, memory issues, and balance problems, which can increase the risk of falls and hip fractures.
It is important to consult a doctor before taking sleep aids, especially for individuals with existing health conditions. Abruptly discontinuing sleep aids can also lead to rebound insomnia, which may be more frustrating than the original insomnia, with symptoms such as vivid dreams, nightmares, and anxiety. Therefore, it is recommended to gradually reduce the dosage under medical supervision.
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Safety concerns with melatonin
Melatonin is a hormone that is naturally produced by the body to promote sleep. It is also available as a supplement to help with occasional insomnia and jet lag. Melatonin supplements are widely used, with a 2022 survey finding that more than 27% of US adults take melatonin to aid sleep.
While melatonin can be effective in helping people fall asleep, there are some safety concerns to be aware of. Firstly, melatonin supplements can have side effects such as nausea, headaches, dizziness, and daytime sleepiness. Although not common, serious allergic reactions (anaphylaxis) to melatonin are possible, with symptoms including swelling of the lips, mouth, throat, or tongue, breathing difficulties, skin discolouration, confusion, and dizziness. It is important to seek immediate medical attention if any of these symptoms occur.
Another concern is the accuracy of labelling on melatonin products. A 2023 study found that 88% of over-the-counter melatonin gummies had inaccurate labels, with the actual quantity of melatonin ranging from 74-347% of the stated amount. This makes it difficult to determine the correct dosage, increasing the risk of overdose. Overdose calls to poison control centres involving melatonin have also increased significantly, with a 530% rise between 2012 and 2021, partly due to the appealing gummy form of many supplements.
Additionally, melatonin can interact with alcohol, increasing its sedative effects. Therefore, it is recommended to avoid alcohol when taking melatonin and not to drive or operate machinery until the effects have worn off. Melatonin may also interact with other medications, so it is important to consult a healthcare provider before taking it.
Finally, while melatonin can be beneficial for some children with sleep issues, it should be used with caution. Healthcare providers generally discourage melatonin use for children under two years old. For older children, it is important to start with a low dose and gradually increase it under the supervision of a pediatrician.
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Natural sleep aids
Melatonin
Melatonin is a hormone that is naturally released in the brain four hours before we feel sleepy. It is triggered by the body's response to reduced light exposure, which should naturally happen at night. However, unnatural light from phones, laptops, or TVs prevents its release, making it hard to fall asleep. Melatonin supplements are available over the counter and can help people fall asleep faster and improve overall sleep quality. However, melatonin can reduce the effectiveness of some medications and cause unwanted side effects when combined with others. It may not be recommended for people who have received organ transplants, experience depression, or have bleeding or seizure disorders.
Magnesium
Magnesium is another natural sleep aid that can help improve sleep quality.
Valerian Root
Valerian is a plant with sedative effects that can promote rest and sleep. It may help postmenopausal women with insomnia, but it is important to consult a doctor before taking it as it may interact with other medications.
Cannabinoids
Some natural sleep aids contain cannabinoids like delta-tetrahydrocannabinol (THC) and cannabidiol (CBD). Studies suggest that THC and CBD can help people fall asleep, stay asleep, and improve sleep quality. However, marijuana and THC products can be addictive, and withdrawal can aggravate sleep problems. CBD has been found to relieve anxiety and improve sleep quality, but more research is needed before it can be routinely recommended for treating sleep disorders.
Other Natural Sleep Aids
Other natural sleep aids include lavender, red ginseng extract, passionflower, and warm milk. While these remedies may not have extensive scientific proof of their effectiveness, they are still worth trying as they are natural and unlikely to cause side effects.
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Cognitive behavioural therapy
While over-the-counter and prescription sleeping pills can be effective in aiding sleep, they can also have side effects and are not recommended for long-term use. Natural sleep aids such as melatonin and valerian supplements are considered safer alternatives, but it is still important to consult a healthcare provider before taking them.
If you are experiencing sleep difficulties, it may be worth considering cognitive behavioural therapy (CBT-I) as a first-line treatment. CBT-I is a short, structured, and evidence-based approach that has been shown to be effective for both short-term and chronic insomnia. The therapy typically involves 5 to 10 sessions with a trained provider, such as a doctor, counsellor, therapist, or psychiatrist, who helps to identify and address the thoughts, feelings, and behaviours that contribute to insomnia.
During CBT-I, patients are guided through a series of changes in sleep-related behaviours. This includes identifying and eliminating habits that were initially developed to improve sleep but have become ineffective, as well as reducing sleep-related worry and arousal. The therapist helps patients re-evaluate their beliefs about sleep and make necessary changes, such as incorporating relaxation techniques to establish healthy pre-sleep habits.
CBT-I techniques involve stimulus control, sleep restriction, and relaxation training. It takes practice, but these exercises help individuals fall asleep faster, improve sleep quality, and feel more rested during the day. The goal is to restructure unhelpful thoughts about sleep and understand the connection between thoughts, feelings, behaviours, and sleep.
In conclusion, while sleep aids may provide temporary relief, they should be used with caution due to potential side effects and risks. CBT-I offers a more comprehensive and long-lasting solution by addressing the underlying factors that contribute to insomnia. It empowers individuals to develop healthier sleep habits and improve their overall sleep hygiene.
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Precautions to take with sleep medicine
Sleep medications can help with insomnia and sleeplessness, but they should be used with caution. Here are some precautions to take when considering sleep medicine:
Consult a Healthcare Professional
Before taking any sleep medication, it is crucial to consult your healthcare provider. They can advise you on the potential risks and side effects and determine if sleep medication is suitable for your specific situation. Discuss any other medications you are currently taking, as well as any underlying health conditions. It is important to be honest and transparent with your healthcare provider to ensure your safety.
Understand the Risks and Side Effects
Sleep medications come with potential side effects and risks. These can include rebound insomnia, nausea, headaches, daytime sleepiness, and complex sleep behaviours. Complex sleep behaviours refer to activities performed while not fully conscious, such as sleepwalking, eating, driving, or even taking medications. These behaviours can be dangerous and may lead to serious consequences. It is important to be aware of these potential side effects and seek immediate medical advice if experienced.
Avoid Mixing with Other Substances
Do not mix sleep medications with alcohol, opioids, antidepressants, or antihistamines. The combination of sleep medicine with these substances can lead to slowed breathing, dizziness, confusion, and even death. Alcohol, in particular, can enhance the sleep effects of the medication, resulting in dangerous outcomes. It is crucial to refrain from consuming alcohol or other sedatives while taking sleep medication to minimise the risk of adverse events.
Follow Dosage Instructions
Adhere strictly to the prescribed dosage instructions. Do not exceed the recommended dosage or frequency of use. Sleep medications can be habit-forming, and prolonged use may lead to dependence and tolerance. Typically, sleep aids are intended for short-term use, and it is important to give yourself time to adjust to new medication. Do not stop taking the medication abruptly, as this may cause withdrawal symptoms.
Explore Alternative Options
Consider alternative approaches to improving sleep before opting for medication. Cognitive behavioural therapy (CBT) is an effective tool to enhance sleep quality and address insomnia. Behavioural changes, such as avoiding large meals and caffeine before bed, quitting smoking, and incorporating relaxation techniques, can also positively impact sleep patterns. These non-drug treatments are often recommended as the first line of defence against insomnia, especially for older adults.
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Frequently asked questions
No, sleep aids are not recommended for long-term use due to potential side effects and risks. They are intended for occasional sleepless nights and short-term bouts of insomnia. If you are experiencing frequent sleep problems, consult a doctor to discuss alternative treatments.
Sleep aids can cause constipation or diarrhoea, muscle weakness, digestive problems, worsened snoring and sleep apnea, and rebound insomnia when discontinued. They may also cause daytime sleepiness, nausea, headaches, and in rare cases, complex sleep behaviours such as driving while not fully conscious.
Natural sleep aids like melatonin and valerian root are popular alternatives to over-the-counter sleep aids. Melatonin is a hormone that helps regulate the sleep-wake cycle, and valerian root is an herb that promotes relaxation. While generally considered safe, there are concerns about the purity and effectiveness of melatonin products due to a lack of regulation. Always consult a healthcare professional before taking any sleep aid, including natural remedies.
