Colin Snow
Sleep is an essential part of staying healthy, and a lack of sleep can cause a range of problems beyond fatigue, including stress, anxiety, and memory issues. While there are many over-the-counter (OTC) and prescription sleep aids available, they often carry risks of side effects, misuse, and dependency. Melatonin is a popular natural sleep aid, but its effectiveness is debated, and it may cause next-day drowsiness, nausea, and headaches. Other OTC sleep aids, such as diphenhydramine and doxylamine, can also cause side effects like dizziness, memory issues, and prolonged grogginess. Prescription sleep aids like trazodone (Desyrel) and suvorexant (Belsomra) may have fewer side effects when taken at lower doses, but they can still increase the effects of alcohol and cause allergic reactions. Before turning to medication, it's recommended to try improving your sleep hygiene by establishing a relaxing bedtime routine, avoiding stimulants like caffeine and alcohol, and creating a quiet, dark, and cool sleep environment.
| Characteristics | Values |
|---|---|
| Type | Non-medicated methods, over-the-counter medication, prescription medication |
| Risk factors | Dependence, memory problems, falls, increased risk of dementia, nausea, headaches, daytime sleepiness, dizziness, grogginess, allergic reactions, misuse, drug interactions |
| Side effects | Dizziness, memory issues, urination problems, nausea, headaches, daytime sleepiness, allergic reactions, edema |
| Availability | Over-the-counter, prescription |
| Administration | Oral |
| Natural alternatives | Valerian, melatonin |
| Lifestyle changes | Regular routine, regular exercise, avoiding stimulants, cool temperature, silence, earplugs, blinds, meditation apps, reading |
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What You'll Learn
Prescription medication
If you are experiencing ongoing difficulties sleeping, it is recommended that you talk to your primary care doctor or a sleep specialist. They can prescribe a sleep aid or refer you for cognitive behavioural therapy to treat insomnia. Prescription sleep aids can often relieve insomnia for short periods, but many of these medications carry risks of side effects, misuse, and dependency. It is important to understand the risks before starting to take any medication for insomnia.
Prescription sleep aids can help people fall asleep, stay asleep, or both. Doctors may suggest people with insomnia use Silenor (Doxepin) for up to 3 months. It is available as an immediate-release tablet in 3 and 6-milligram doses. Rozerem (a melatonin agonist) is not a controlled substance and has a low likelihood of misuse or dependency. Suvorexant (Belsomra) may help a person fall asleep and maintain sleep, but it is only available as a brand-name medication and has a risk of misuse and dependency. Trazodone (Desyrel) is a medication that modulates the neurotransmitter serotonin and is typically used to treat major depressive disorder.
Other medications commonly used to treat insomnia include benzodiazepines (Ativan, Valium, Restoril), atypical benzodiazepines (Ambien, Sonata, Lunesta), melatonin agonists (Rozerem), antidepressants (Silenor, amitriptyline, trazodone), and the newest one, Belsomra. It is important to note that medications to treat insomnia can be dangerous for older adults, as they may experience more intense side effects and are more likely to become physically dependent on habit-forming medications. Mixing sleep medications with alcohol or other sedating medications can be fatal. Therefore, it is crucial to work closely with your healthcare provider and use the lowest effective dose.
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Over-the-counter medication
Over-the-counter (OTC) sleep aids can be a good solution for temporary sleep problems, such as short-term insomnia. However, it's important to be cautious when using them, as they are not a good long-term solution. It is always recommended to consult a doctor or healthcare provider before taking any sleep medication to understand the options, benefits, side effects, possible drug interactions, and risks.
OTC sleep aids include non-prescription sleeping pills, natural supplements, and antihistamines. Antihistamines such as diphenhydramine (found in Benadryl) and doxylamine are common ingredients in OTC sleep aids. They work by blocking the body's histamine reaction, which includes alertness, thus making you feel drowsy. However, long-term use of antihistamines has been associated with an increased risk of dementia and memory issues.
Natural supplements like melatonin, which is a hormone that regulates the sleep-wake cycle, are also available as OTC sleep aids. They are most effective for people with circadian rhythm sleep disorders. However, it is important to note that herbal supplements are not regulated by the FDA, so the amount of the substance in the sleep aid may vary.
Other natural remedies that do not require OTC medications include soothing teas, magnesium, potassium, L-Lysine, passionflower extract, valerian root extract, and CBD. Lifestyle adjustments, such as exercising during the day, avoiding large meals, alcohol, and caffeine before bed, and changing your sleep environment, can also help improve your sleep quality.
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Non-medicated methods
Melatonin
Melatonin is a sleep-regulating hormone produced by the pineal gland in the brain. It plays a significant role in organising our circadian rhythms, the 24-hour sleep-wake cycles that govern when we sleep, feel alert, and feel tired. While it is a popular supplement, it is not recommended for regular use. Instead, it is more helpful for shifting your sleep schedule, such as when travelling across time zones. Melatonin can also reduce the effectiveness of some medications and produce unwanted side effects when combined with others.
Valerian Root
The dried root of this herbal plant is made into pills, teas, or other formulas meant to improve sleep. Research is mixed, but there is some evidence that valerian can help people fall asleep faster and sleep more soundly.
Lavender Essential Oil
Lavender oil is available in a variety of products such as lotions, bath salts, and sheet sprays. While there is no established reason for essential oils to have a physiological effect on the sleep system, the psychological effect of helping you relax and unwind can help you sleep.
Herbal Tea
Teas made for drinking at bedtime usually contain herbal blends such as passionflower and chamomile (and sometimes valerian).
Cognitive Behavioural Therapy
Therapists can help you focus on stressors that keep you up at night. Over the course of several visits, you work through how to calm your mind when those stressors occur. It takes practice, but these exercises will help you fall asleep and stay asleep.
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Herbal remedies
Valerian Root (Valeriana officinalis): Valerian is a herb that has been used since ancient times to aid sleep. It is considered safe and is regulated by the FDA as a dietary supplement. Valerian root is one of the key ingredients in ZzzQuil PURE Zzzs Restorative Herbal Sleep, a melatonin-free sleep aid.
Hops (Humulus lupulus): Hops are flower cones from the hemp plant family, primarily cultivated in central Europe. When combined with valerian root, these herbs work synergistically to promote sleep by increasing alpha waves during the early stages of sleep. Hops are also an ingredient in ZzzQuil's herbal sleep aid.
Passion Flower (Passiflora incarnata): Passion flower is a woody, climbing vine found in warm temperate and tropical regions. It was traditionally used by Native American Indians and is now an ingredient in ZzzQuil's herbal sleep blend. Studies show that passion flower can help promote better, restorative sleep.
Milky Oats (Avena sativa): Milky oats are prepared by expressing the juices of immature oats and made into a tincture. They are believed to be a nervous system restorative and nutritive tonic, recommended for those who are emotionally or physically depleted.
Skullcap (Scutellaria lateriflora): Skullcap is a common weed, and its dried parts can be used to make a tea. Skullcap is believed to contain flavonoids that interact with benzodiazepine receptors in the brain, which are involved in the sleep-wake transition.
In addition to these herbal remedies, there are also natural lifestyle adjustments that can improve sleep, such as maintaining a cool temperature in the bedroom, minimising light exposure from electronic devices, and consuming drinks like warm milk, chamomile tea, or tart cherry juice, which may support melatonin production and a healthy sleep cycle.
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Lifestyle changes
Maintain a consistent sleep schedule
Try to go to bed and wake up at the same time every day, even on weekends. This helps to regulate your body's internal clock and can improve the quality of your sleep.
Establish a relaxing bedtime routine
Engage in activities that help you relax and prepare for sleep. This could include reading a book, listening to soothing music, practising meditation or deep breathing exercises, or taking a warm bath. Avoid stimulating activities, such as watching TV or using electronic devices, close to bedtime, as the blue light emitted by these devices can interfere with your sleep.
Create a sleep-conducive environment
Make sure your bedroom is cool, dark, quiet, and comfortable. Consider using earplugs, eye masks, or white noise machines to create a peaceful sleep environment.
Regular physical exercise
Exercising regularly can help improve your sleep quality. However, avoid vigorous exercise close to bedtime, as it may make it harder to fall asleep. Aim for at least 30 minutes of moderate exercise, such as walking or swimming, most days of the week.
Avoid stimulants and alcohol
Caffeine, nicotine, and alcohol can interfere with your sleep. Avoid consuming these substances close to bedtime, and limit your intake throughout the day. Instead, opt for sleep-promoting foods and drinks, such as chamomile tea or tart cherry juice.
Manage stress
Stress and anxiety can make it difficult to fall asleep. Try incorporating relaxation techniques into your daily routine, such as yoga, meditation, or deep breathing exercises. Also, keep a notepad and pen by your bed to jot down any worries or tasks that pop into your head, so you can deal with them in the morning instead of lying awake thinking about them.
Remember, if you are considering taking any sleep aids or supplements, it is always best to consult your healthcare provider first to ensure they are safe and appropriate for you.
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Frequently asked questions
Natural sleep aids include herbal teas such as chamomile, warm milk, tart cherry juice, melatonin, magnesium, and valerian root.
Non-medicated sleep aids include eye masks, earplugs, room freshening sprays with lavender oil, knee pillows, and acupressure mats.
Over-the-counter sleep aids include antihistamines such as Benadryl, Unisom, and ZzzQuil. However, these should be used sparingly and only as a short-term solution.
