Gina Johnson
Sleep disturbances are common, with an estimated 50 to 70 million people in the United States experiencing chronic sleep or wakefulness conditions. Sleeping pills are one way to treat insomnia and other sleep disorders, and they are available over the counter (OTC), as natural supplements, or by prescription. OTC sleeping pills often contain antihistamines, which block the histamines in your body that cause alertness, while prescription sleep medications can include benzodiazepines, which stimulate a calming chemical in the brain called GABA, and Z-drugs, which slow brain activity. Common prescription sleeping pills include Ambien, Restoril, and Belsomra, while OTC options include Benadryl Allergy, Advil PM, and Tylenol PM. Natural sleep aids include melatonin and valerian supplements.
| Characteristics | Values |
|---|---|
| How they work | OTC sleeping pills contain antihistamines, which block histamines that cause alertness. Prescription sleep medications work in different ways, such as stimulating GABA, a chemical in the brain that leads to sedation. |
| Natural alternatives | Melatonin, a hormone that promotes sleep; valerian, an herb that aids relaxation; cognitive behavioral therapy (CBT). |
| Side effects | Confusion, sleepiness during the day, parasomnia, constipation, muscle weakness, memory issues, balance problems, allergic reactions, hallucinations, mood changes, and more. |
| Risks | Older adults are at higher risk of side effects, including confusion, memory issues, and balance problems. Pregnant people should not take Restoril. Many sleep medications carry risks of misuse, dependency, and interaction with other substances. |
| Common prescription medications | Zolpidem (Ambien, Intermezzo, Zolpimist), Zaleplon (Sonata), Doxepin (Silenor), Triazolam (Halcion), Temazepam, Ramelteon (Rozerem), Suvorexant (Belsomra), Quviviq, Lunesta, Restoril. |
| Common over-the-counter medications | Benadryl Allergy, Advil PM, Tylenol PM, Unisom, ZzzQuil. |
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What You'll Learn
- Over-the-counter sleep aids: Benadryl, Advil PM, Tylenol PM, Unisom, ZzzQuil
- Natural sleep aids: Melatonin, Valerian
- Prescription sleep aids: Sonata, Ambien, Intermezzo, Zolpimist, Lunesta, Restoril, Silenor, Rozerem, Belsomra
- Prescription sleep aids with high dependency risk: Zolpidem, Zaleplon, Eszopiclone, Triazolam, Temazepam
- Side effects: Confusion, sleepiness, parasomnia, constipation, muscle weakness, hangover effect
Over-the-counter sleep aids: Benadryl, Advil PM, Tylenol PM, Unisom, ZzzQuil
Over-the-counter (OTC) sleep aids are widely available without a prescription and can help people with sleep troubles. However, sleep experts advise against the use of antihistamines as sleep aids due to their side effects and overall lack of benefit to sleep quality.
Benadryl
Benadryl is an antihistamine medication that is commonly used to treat allergies. While it can make people feel sleepy, sleep experts advise against using it as a sleep aid due to its side effects, which include an altered mental state, urinary retention, and dry mouth. Benadryl is also an ingredient in Tylenol PM.
Advil PM
Each Advil PM caplet combines 200 mg of ibuprofen, a pain reliever, with 38 mg of diphenhydramine citrate, a gentle sleep aid. Advil PM relieves pain and helps people fall asleep faster, sleep longer, and achieve a better night's sleep. The recommended dose for adults and children 12 years and older is two caplets at bedtime, not exceeding two caplets in 24 hours.
Tylenol PM
Tylenol PM is an over-the-counter medication that contains acetaminophen and diphenhydramine, an antihistamine. It helps people with insomnia fall asleep faster and stay asleep longer. However, some people have reported negative side effects, including feeling restless, anxious, and nervous the next day, as well as experiencing withdrawal symptoms upon stopping use.
Unisom
Unisom offers various sleep aid products, including SleepTabs, SleepGels, SleepMinis, SleepMelts, and PM. The SleepTabs contain doxylamine succinate, a non-habit-forming antihistamine that helps people fall asleep faster and wake up feeling refreshed. Other products contain diphenhydramine or melatonin and other natural ingredients like passionflower, lemon balm, and Vitamin B6.
ZzzQuil
ZzzQuil is an over-the-counter sleep aid that contains diphenhydramine HCI, a non-habit-forming ingredient that helps people get the sleep they need. It is intended for occasional sleeplessness.
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Natural sleep aids: Melatonin, Valerian
Natural sleep aids: Melatonin and Valerian
Melatonin
Melatonin is a natural sleep hormone produced by the body. Melatonin does not induce sleep but instead puts the body into a state of quiet wakefulness that helps promote sleep. Melatonin production is triggered by the absence of light, with production typically starting in the evening as the sun goes down. This causes a gradual increase in sleepiness, peaking about seven hours later, and helping a person stay asleep through the night. Melatonin drops to undetectable levels in the morning as exposure to light inhibits its production, helping a person feel alert.
Melatonin sleep aids have grown in popularity, with 3 million Americans using them in 2012. Melatonin supplements may be appropriate for adults experiencing insomnia, jet lag, or for night owls who need to adjust their sleep schedules. It is recommended to take 1 to 3 milligrams of melatonin two hours before bedtime. Melatonin is considered safe for most people to take nightly for one to two months. However, it is advised not to use melatonin if pregnant, breastfeeding, or if you have an autoimmune disorder, seizure disorder, or depression.
Valerian
Valerian is an herb used to promote relaxation and sleep. The roots, rhizomes, and stolons of the valerian plant are used to make dietary supplements such as capsules, tablets, teas, and tinctures. While the exact mechanism of how valerian works in the body is not fully understood, research suggests that it is related to the action of compounds found in the plant, including valerenic acid and valerenol. These compounds can act on GABA receptors in the body, helping to regulate nerve impulses in the nervous system and resulting in sedative effects.
It is important to speak with a healthcare professional before taking valerian, especially if you are taking medications or have health conditions. While valerian is marketed as a natural sleep enhancer, it may not be the right solution for everyone, and it is critical to understand the underlying causes of sleep issues.
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Prescription sleep aids: Sonata, Ambien, Intermezzo, Zolpimist, Lunesta, Restoril, Silenor, Rozerem, Belsomra
Sonata (Zaleplon)
Zaleplon, commonly known as Sonata, is a prescription sleep aid. It is a controlled substance that can be misused or lead to dependence. It is typically taken right before getting into bed or when one is in bed but is having trouble falling asleep. It should not be taken with food or alcohol, as this may increase the risk of feeling drowsy or dizzy the next day. Zaleplon may cause short-term memory loss and unusual sleep-related behaviours, such as sleep-walking, sleep-driving, or making phone calls.
Ambien (Zolpidem)
Ambien, also known as Zolpidem, is a prescription sedative used to treat insomnia. It helps individuals fall asleep and stay asleep, with both immediate and extended-release options available. Zolpidem affects chemicals in the brain that may be unbalanced in people with insomnia. It may cause a severe allergic reaction and unusual sleep-related behaviours, such as driving, eating, walking, making phone calls, or having sex, with no memory of the activity. Zolpidem may also impair thinking or reactions, and it is not recommended for those allergic to lactose, as the tablets may contain lactose.
Intermezzo (Zolpidem Sublingual)
Intermezzo, or Zolpidem Sublingual, is a sedative or hypnotic prescription sleep aid used to treat insomnia. It is characterised by middle-of-the-night waking followed by difficulty falling back asleep. Intermezzo should be taken when at least four hours of bedtime remain and should not be consumed with alcohol or other sleep aids. It may cause a severe allergic reaction and unusual sleep-related behaviours.
Zolpimist (Sleep Spray)
Zolpimist is a sedative or hypnotic prescription sleep aid used for the short-term treatment of insomnia in adults. It is available as an oral spray. Zolpidem, the active ingredient, affects chemicals in the brain that may be unbalanced in people with insomnia. It may cause a severe allergic reaction and unusual sleep-related behaviours, similar to those associated with Ambien. Zolpidem may also impair thinking or reactions, and it is not recommended for those allergic to zolpidem or under the age of 18.
Lunesta (Eszopiclone)
Lunesta, or Eszopiclone, is a sedative or hypnotic prescription medication used to treat insomnia. It helps reduce the time it takes to fall asleep and increases total sleep time, typically beginning to work within 30 minutes. Lunesta carries a boxed warning for complex sleep behaviours, which have caused injuries and deaths. Individuals taking Lunesta may engage in activities while not fully awake, such as sleep-walking, sleep-driving, preparing food, making phone calls, or having sex, with no memory of these activities. Lunesta may also cause worsening depression and suicidal thoughts or actions in those with pre-existing depression. It should not be taken with alcohol, as this can increase side effects, including drowsiness.
Restoril (Temazepam)
Restoril, or Temazepam, is a prescription benzodiazepine sedative-hypnotic used to treat insomnia. It produces a calming effect on the brain and nerves, helping individuals fall asleep and reducing how often they wake up during the night. Temazepam may affect alertness and coordination, so it is important not to drive or engage in activities requiring alertness until the effects are understood. It should not be taken with alcohol, as this increases the risk of severe dizziness, sleepiness, and trouble breathing.
Silenor (Doxepin)
Silenor, or Doxepin, is a prescription medication used to treat insomnia. It is taken 30 minutes before bedtime and should be taken on an empty stomach. Doxepin can affect alertness and coordination, so it is important not to drive or engage in activities requiring alertness until the effects are understood. It can also increase skin sensitivity to light, so caution is needed when exposed to sunlight or tanning beds. Doxepin should not be taken with alcohol, as this can increase sleepiness and affect alertness and concentration.
Rozerem (Ramelteon)
Rozerem, or Ramelteon, is a prescription hypnotic and melatonin receptor agonist used to treat insomnia. It mimics the effect of melatonin, a naturally occurring substance in the body that aids sleep. Ramelteon can cause dizziness and tiredness and affect alertness and coordination, even the day after taking it. It should not be taken with alcohol, as this can worsen sleep problems.
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Prescription sleep aids with high dependency risk: Zolpidem, Zaleplon, Eszopiclone, Triazolam, Temazepam
Zolpidem, Zaleplon, Eszopiclone, Triazolam, and Temazepam are prescription sleep aids that carry a risk of dependency and, in some cases, fatal overdose. These medications are typically prescribed for short-term insomnia relief, and patients should be carefully monitored by their doctors to prevent misuse and abuse.
Zolpidem, also known by the brand names Ambien, Intermezzo, and Zolpimist, is a Z-drug that helps with falling asleep and sleep maintenance. It has a short half-life, making it particularly useful for treating sleep-onset insomnia. However, zolpidem has been associated with complex sleep behaviours and a high risk of misuse, abuse, and dependency. It has also been implicated in fatalities, particularly when ingested with other drugs.
Zaleplon, or Sonata, is another Z-drug used for short-term insomnia treatment. It has an even shorter half-life of approximately one hour and is primarily used for sleep initiation. While zaleplon has lower toxicity and fewer reported fatalities than other Z-drugs, it still carries a risk of misuse, abuse, and dependency. It is also associated with a high likelihood of misuse and side effects such as hallucinations, mood changes, and memory loss.
Eszopiclone, marketed as Lunesta, is a newer Z-drug that helps individuals fall and stay asleep. It is generally considered safe, but it carries a risk of misuse, dependency, and complex sleep behaviours such as sleepwalking or driving while asleep. The effects of eszopiclone may diminish over time, and it may cause side effects in some individuals.
Triazolam, sold under the brand name Halcion, is a benzodiazepine prescribed for the short-term treatment of insomnia, typically for 7 to 10 days. It carries a risk of dependency and overdose, and its misuse has been associated with fatalities.
Temazepam, or Restoril, is another benzodiazepine medication used for short-term insomnia relief. It increases total sleep time, reduces initial sleep latency, and decreases wakefulness after sleep onset. Temazepam has a half-life ranging from 6 to 16 hours, making it a reasonable choice among benzodiazepines for inducing sleep. However, it can cause dependency and addiction if misused.
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Side effects: Confusion, sleepiness, parasomnia, constipation, muscle weakness, hangover effect
Sleeping pills are often used to treat insomnia and other sleep disorders. They can be effective in helping individuals fall asleep and stay asleep. However, it is important to be aware of the potential side effects associated with their use. While side effects may vary among different medications and individuals, some of the most commonly reported side effects include drowsiness, confusion, parasomnias, constipation, muscle weakness, and a hangover effect, which will be discussed in further detail.
Confusion
Sleep medications can cause confusion and cognitive impairment. Individuals may experience difficulties with focus, memory, and attention. This side effect can be particularly dangerous for older adults, as it increases the risk of falls, accidents, and injuries. It is advised that individuals taking sleeping pills refrain from driving or operating heavy machinery until the effects have worn off.
Sleepiness
Daytime sleepiness is a common side effect of sleeping pills. This can impact an individual's ability to function during the day, leading to difficulties with work, operating machinery, or performing tasks that require focus and attention. The drowsiness caused by sleeping pills can extend into the next day, especially for older adults, as the pills tend to remain in their system for a longer duration.
Parasomnia
Parasomnias are complex sleep behaviours that occur while an individual is still mostly asleep. Some people taking sleeping pills may experience parasomnias such as sleepwalking, sleep eating, making phone calls, or even sleep driving. These behaviours can be dangerous and may result in injuries or accidents. Parasomnias are rare but challenging to detect once the medication takes effect.
Constipation
Sleeping pills can cause constipation, particularly in older adults. This side effect can be uncomfortable and impact an individual's overall well-being. It is important to stay hydrated and maintain a balanced diet to help alleviate this issue.
Muscle Weakness
Sleep medications can lead to muscle weakness and motor coordination problems. This side effect can impact an person's physical abilities and make it difficult to perform daily tasks or activities that require physical strength and coordination.
Hangover Effect
The "hangover" effect is a common side effect of sleeping pills, including benzodiazepines, sedative hypnotics, and zopiclone. This effect refers to symptoms such as drowsiness, impaired balance, and coordination, as well as impaired focus and memory the morning after taking the medication. This effect can impact an individual's ability to drive or perform tasks requiring concentration and attention.
It is important to consult a healthcare professional before taking sleeping pills and to be aware of potential side effects. Sleeping pills are generally recommended for short-term use, as long-term use can lead to dependence and other problems.
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Frequently asked questions
Common over-the-counter (OTC) sleeping pills include Benadryl Allergy®, Advil PM® and Tylenol PM®. Most OTC sleeping pills contain antihistamines, which block histamines—the substances in your body that cause alertness. Common antihistamine ingredients include diphenhydramine and doxylamine.
Natural sleep aids include melatonin and valerian. Melatonin is a hormone that your body naturally produces to promote sleep. Valerian is an herb that has a natural calming effect on your nervous system.
Common prescription sleeping pills include Sonata (zaleplon), Ambien (zolpidem), Intermezzo, Zolpimist, Lunesta, Restoril, and Belsomra. Many of these medications carry risks of side effects, misuse, and dependency, so you should consult a doctor before starting any new sleep medication.
