Daytime Sleeping Aids: Do They Work?

Sleep is an essential part of staying healthy, and a lack of sleep can cause a range of problems, from reduced concentration to a higher risk of heart disease and dementia. While good sleep habits are important, there are also many sleep aids available to help you fall asleep and stay asleep. These include natural remedies such as melatonin and valerian root, over-the-counter antihistamines like diphenhydramine and doxylamine succinate, and prescription sleeping pills such as benzodiazepines and Z-drugs. However, it's important to be aware of the potential side effects and risks associated with these sleep aids, and to consult a healthcare professional before taking any new medications or supplements.

Natural sleep aids, such as melatonin, magnesium, and valerian root

Melatonin

Melatonin is a hormone naturally produced by your body that signals to your brain that it's time to sleep. The production and release of melatonin are influenced by the time of day, with levels typically rising in the evening and falling in the morning. This hormone's cycle can be disrupted by factors such as jet lag, leading to sleep issues. Melatonin supplements have become a popular sleep aid, and studies show they can improve daytime sleep quality and duration. They are particularly beneficial for those who need to sleep during the day, such as shift workers. Melatonin appears to reduce the time it takes to fall asleep and increase total sleep time. It is generally safe for adults when used for short periods, but more research is needed on its long-term effects. Melatonin is not recommended for pregnant or nursing individuals due to limited safety research. Typical melatonin supplement doses range from 3 to 10 milligrams, taken before bedtime.

Magnesium

Magnesium is a mineral that plays a role in numerous bodily processes and is crucial for brain function and heart health. It can help quiet the mind and body, making it easier to fall asleep. Magnesium's relaxing effect is partly due to its ability to regulate melatonin production and relax muscles. Studies suggest that insufficient magnesium levels may be linked to troubled sleep and insomnia. Magnesium supplements, often combined with other sleep-promoting ingredients, can help optimize sleep quality and quantity. The typical recommended dose is 225-729 mg daily, but it's important not to exceed 350 mg unless advised by a healthcare professional.

Valerian Root

Valerian is an herb native to Asia and Europe, and its root is commonly used to treat symptoms of anxiety, depression, and menopause. It is also one of the most popular sleep-promoting herbal supplements in the US and Europe. Valerian root has shown mixed results in studies, with some indicating improvements in sleep quality, latency, and duration, while others found negligible effects. Short-term intake of valerian root appears safe for adults, but its safety for long-term use and specific populations, including pregnant and nursing individuals, is uncertain. Typical valerian root supplement doses range from 300 to 600 mg.

Over-the-counter sleep aids with antihistamines: diphenhydramine and doxylamine succinate

Diphenhydramine and doxylamine succinate are antihistamines that are sold over the counter. They are not primarily used as sleep aids, but they can cause drowsiness and have been used to promote sleep. They are both sedating antihistamines that help make you sleepy by decreasing histamine levels in your brain, which is how the brain naturally prepares for sleep.

Diphenhydramine is the active ingredient in allergy medications such as Benadryl. It is also found in ZzzQuil, Unisom SleepGels, and Unisom SleepMelts. Doxylamine succinate is the active ingredient in the sleep aid Unisom SleepTabs and is also found in Nyquil.

The evidence that these ingredients are effective as sleep aids is weak, and many experts recommend against their use. Diphenhydramine and doxylamine succinate are not recommended for regular use due to their side effects and risks. These include an increased risk of dementia for older adults, grogginess during the day, and trouble emptying the bladder. They are also not recommended for people who are pregnant or breastfeeding, or those with closed-angle glaucoma. Additionally, people with respiratory conditions, high blood pressure, or heart disease should avoid these drugs as they may induce a nervous system reaction that leads to an elevated heart rate.

If you are considering taking diphenhydramine or doxylamine succinate as sleep aids, it is recommended to use them only occasionally as more research is needed on their long-term safety and effectiveness. It is important to be aware of the possible side effects and risks associated with these drugs and to consult your doctor before use.

Prescription sleep aids: Zolpidem, Zolpidem Extended Release, etc

Prescription sleep aids are stronger than over-the-counter ones and are typically recommended for short-term relief. They include benzodiazepines (benzos) and Z-drugs such as zolpidem (Ambien) and eszopiclone (Lunesta).

Zolpidem is a sedative-hypnotic drug that slows down brain activity to induce sleep. It comes in various forms, including immediate-release and extended-release tablets, sublingual tablets, and an oral spray. The immediate-release forms, such as Ambien, Edluar, and Zolpimist, help you fall asleep, while Intermezzo helps you fall back asleep if you wake up in the middle of the night. The extended-release form, Ambien CR, has a two-layer design to help you fall and stay asleep.

Zolpidem is typically taken right before bedtime on an empty stomach, and users should ensure they have a full 7 to 8 hours of sleep ahead of them. It is only intended for short-term use, and users should consult a doctor if their symptoms do not improve after 7 to 10 days.

Zolpidem may cause side effects, including daytime drowsiness, dizziness, and a light-headed feeling. More serious side effects include anxiety, depression, aggression, confusion, hallucinations, memory problems, and unusual thoughts or behaviour. It may also cause a severe allergic reaction, and users should seek emergency medical help if they experience hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.

Zolpidem may also cause serious or life-threatening sleep behaviours. Some users have engaged in activities such as driving, eating, walking, making phone calls, or having sex while not fully awake, and later have no memory of these activities. It is crucial to inform your doctor if such behaviours occur, and to stop taking zolpidem if you find out you have been engaging in any unusual activities while asleep.

Non-medicated methods: sleep hygiene, soothing teas, etc

Sleep is incredibly important for your physical and mental health. Poor sleep can negatively affect your memory, concentration, and mood, and it can increase your risk for depression, obesity, type 2 diabetes, heart disease, and high blood pressure.

If you're struggling to sleep during the day, there are several non-medicated methods that may help. Here are some tips to improve your sleep hygiene and create a soothing environment:

• Maintain a cool temperature: Keep your bedroom temperature between 65 and 72 degrees Fahrenheit. If you're taking a nap during the day, use a fan or air conditioning to keep the room cool.
• Minimize light exposure: Natural daylight can interfere with your sleep during the day. Use blackout curtains or thick blinds to block out sunlight. If you need to get up, use a flashlight or night light instead of turning on bright lights.
• Limit screen time: The blue light emitted by smartphones, laptops, and TVs can disrupt your sleep. Avoid screens for at least an hour before your nap.
• Create a comfortable sleep environment: Sleep in layers so you can easily adjust your temperature. Wear breathable fabrics, especially if you tend to get hot during the day.
• Establish a bedtime routine: A consistent bedtime routine can help signal to your body that it's time to wind down. This could include meditation, listening to relaxing music, or sipping on a soothing tea.
• Avoid caffeine and alcohol: Caffeine and alcohol can interfere with your sleep. Avoid consuming them close to your nap time. Instead, opt for drinks like chamomile tea, valerian root tea, or warm milk, which may have sleep-promoting properties.

Speaking of teas, here are some soothing options that may help you relax and unwind before your daytime sleep:

• Chamomile tea: This herbal tea has a delicate floral flavor and is often used to promote sleep thanks to its sedative effects. It's caffeine-free and has been found to safely improve sleep quality.
• Lavender tea: Lavender is known for its calming properties. Drinking lavender tea has been shown to reduce fatigue and improve sleep quality, especially in women who have recently given birth.
• Low-caffeine green tea: While green tea contains some caffeine, opting for a low-caffeine version can provide the benefits of green tea without interfering with your sleep. Some studies suggest that green tea can improve sleep quality and battle insomnia.
• Magnolia tea: This tea is made from the dried bark, buds, and stems of the magnolia plant and is often used as a natural sleep aid in traditional medicine. It contains compounds with sedative effects, although more research is needed to confirm its effectiveness.
• Passionflower tea: Passionflower is known for its medicinal properties, and passionflower tea has been found to act as a natural sedative and help relieve anxiety.

Remember, these teas may not work for everyone, and they should be used alongside other healthy sleep habits. Always consult a healthcare professional if you have any concerns or questions about your sleep habits.

Cognitive Behaviour Therapy

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a short, structured, evidence-based approach to improving sleep quality and treating insomnia. CBT-I is considered effective for both short-term and chronic insomnia. It is a collaborative process that involves restructuring the thoughts, feelings, and behaviors that contribute to insomnia.

CBT-I typically involves cognitive, behavioral, and educational interventions. Cognitive interventions involve cognitive restructuring, which aims to change inaccurate or unhelpful thoughts about sleep. Behavioral interventions include stimulus control, sleep restriction, and relaxation training. Psychoeducational interventions involve educating patients about the connection between thoughts, feelings, behaviors, and sleep.

During CBT-I, a trained provider helps identify thoughts, feelings, and behaviors that contribute to insomnia. They examine thoughts and feelings about sleep and test whether they are accurate. Behaviors are examined to determine if they promote sleep. Misconceptions and challenges are then clarified or reframed in a way that is more conducive to restful sleep.

Therapy techniques used in CBT-I include:

• Breathing exercises: Involves taking slow, deep breaths to reduce feelings of anxiety, anger, and depression, and increase slow heart rate and breathing.
• Progressive muscle relaxation: A technique that involves tensing and relaxing different muscle groups, often combined with breathing exercises or guided imagery.
• Autogenic training: A technique that focuses on different parts of the body and specific sensations such as heaviness, warmth, or relaxation.
• Biofeedback: Using technology to monitor processes in the body, such as brain waves, heart rate, breathing, and body temperature.
• Hypnosis: Learning to relax in response to a verbal or non-verbal cue.
• Meditation: Learning to focus attention and practicing movement, such as yoga and tai chi.

CBT-I also involves psychoeducation about good sleep hygiene, which includes increasing practices that encourage sleep and decreasing those that discourage it. Patients may be advised to maintain a sleep schedule, avoid lying awake in bed, create a nightly routine, and consider daytime activities that promote sleep.

The majority of patients respond to CBT-I quickly, with some experiencing significant changes after two sessions. Most patients improve after four to six sessions, but some may require more. Both group and individual treatments have been found to be effective.

Frequently asked questions