Gina Johnson
Sleep is critical for good health, but many people have trouble sleeping. The sleep aid market is vast, but it can be hard to tell which products actually work. Sleep aids work by producing a sedative effect that slows down the nervous system, reducing breathing and heart rate. Most sleep aids work within 30 minutes to an hour, but they are not meant to be taken long-term. Over-the-counter sleep aids can interfere with other medications and may have side effects such as constipation, muscle weakness, and digestive problems. Natural sleep aids, such as melatonin and valerian, are popular but should also be used with caution. Prescription sleep aids are stronger but also carry a risk of dependence and addiction.
| Characteristics | Values |
|---|---|
| Type | Over-the-counter, Prescription |
| Ingredients | Antihistamines, Melatonin, Valerian, Benzodiazepines, Z-drugs |
| Effectiveness | OTC sleep aids are effective for occasional sleepless nights but are not a long-term solution. |
| Side Effects | Drowsiness, Diarrhea, Muscle Weakness, Digestive Problems, Grogginess, Addiction, Dependence |
| Precautions | Consult a doctor before use, especially if you have existing conditions or are on other medications. |
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What You'll Learn
Natural sleep aids
Some natural sleep aids that may help improve your sleep include:
- Melatonin supplements: Melatonin is a hormone that is naturally released in the brain four hours before we feel a sense of sleepiness. It is triggered by the body's response to reduced light exposure, which should occur naturally at night. However, exposure to unnatural light from sources such as phones, laptops, or TVs can prevent melatonin release, making it hard to fall asleep. Melatonin supplements are available over the counter, but it is important to note that they are not regulated by the FDA, so dosages and ingredients may vary. Melatonin can also reduce the effectiveness of some medications and produce unwanted side effects when combined with others. It may not be recommended for people with certain conditions, such as depression or a seizure disorder.
- Valerian: Valerian root is a herbal plant that has been used as a sleep aid for hundreds of years. It has a natural calming effect on the nervous system and can help promote better sleep. It may raise the levels of GABA, a chemical in the brain that boosts relaxation and sleep. Valerian is thought to be safe for short-term use but can sometimes cause headaches and stomachaches. It can be taken as a pill or brewed as a tea.
- Tart cherry juice: Cherries are a natural source of melatonin, and early research suggests that drinking tart cherry juice raises melatonin levels in the body, helping people sleep more soundly and for longer. It is recommended to sip a cup about one or two hours before bedtime.
- Herbal tea: Teas made for bedtime usually contain herbal blends such as passionflower, chamomile, and sometimes valerian. Chamomile tea is believed to contain flavonoids that may interact with benzodiazepine receptors in the brain involved in the sleep-wake transition.
- Lavender essential oil: Lavender essential oil can be found in products such as lotions, bath salts, and sheet sprays. While there is no established physiological effect on the sleep system, the psychological effect of helping you relax and unwind can promote sleep.
- Antihistamines: Antihistamines work by blocking histamines, which are substances in the body that cause alertness. Common ingredients in antihistamines include diphenhydramine and doxylamine. Products such as Benadryl, Unisom, and ZzzQuil are marketed as sleep aids and can help most people fall asleep, but they should be used with caution and started at a low dose to avoid grogginess in the morning. Regular use is not recommended as it can lead to rebound insomnia when discontinued.
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Over-the-counter sleep aids
Over-the-counter (OTC) sleep aids are medications that can be bought without a prescription and may help with occasional sleeplessness. They are generally safe for short-term use but are not recommended for chronic insomnia. While OTC sleep aids are easily accessible, it is important to consult a healthcare provider before trying them, as they may interfere with other medications or health conditions.
OTC sleep aids typically fall into two categories: antihistamine-containing sleep aids and natural sleep aids. Antihistamines, such as diphenhydramine (Benadryl) and doxylamine succinate, work by blocking histamines, which are substances in the body that cause alertness. These antihistamines are found in many non-prescription sleep and allergy medicines, such as Unisom and ZzzQuil. However, they can cause side effects like daytime drowsiness, blurred vision, constipation, dry mouth, and trouble urinating. It is important to use these medications with caution and start with the lowest possible dose, as they can also lead to a "rebound effect," resulting in worse insomnia when discontinued.
Natural sleep aids include supplements like melatonin, valerian, and CBD, which are not regulated as strictly as other medications. Melatonin is a hormone that regulates the sleep-wake cycle, and while it is popular, experts advise against relying on it as a sleep aid. Valerian has a calming effect on the nervous system, and although research is mixed, it may help people fall asleep faster and improve sleep quality. CBD is another option that may aid in sleep, but more research is needed to fully understand its effectiveness and any potential side effects.
In addition to these options, forming good sleep habits, also known as "sleep hygiene," is crucial for improving sleep. This includes maintaining a consistent bedtime, keeping the bedroom temperature cool, avoiding screens before bedtime, and creating a relaxing bedtime routine through activities like reading or listening to soothing music.
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Prescription sleep aids
Benzodiazepines
Benzodiazepines are a class of medications that work by stimulating a brain chemical called GABA, resulting in sedation, muscle relaxation, and reduced anxiety. They are often used as sleep aids due to their ability to promote sleep and reduce alertness. Examples of benzodiazepines used as sleep aids include diazepam and zolpidem (Ambien, Intermezzo, Zolpimist). It is important to note that zolpidem may cause complex sleep behaviors and should be used with caution during pregnancy.
Nonbenzodiazepine Receptor Agonists
Nonbenzodiazepine receptor agonists, such as zaleplon, zolpidem, and eszopiclone (Lunesta), are selective for GABAA receptors, resulting in fewer adverse effects than non-selective benzodiazepine receptor agonists. They are often prescribed for short-term insomnia relief and can help with falling asleep and maintaining sleep.
Antidepressants
Certain antidepressants can be used off-label as sleep aids due to their drowsiness side effects. For example, trazodone (Desyrel), a medication that modulates serotonin, is typically used to treat major depressive disorder but can be prescribed off-label to help with sleep. It is important to note that trazodone may increase thoughts of suicide and should be used with caution along with alcohol limitation.
Orexin Receptor Antagonists
Orexin receptor antagonists, such as suvorexant (Belsomra) and daridorexant, block the binding of neuropeptides that promote wakefulness. These medications are indicated for insomnia characterized by difficulty falling asleep or maintaining sleep. While suvorexant may increase the risk of misuse and dependency, daridorexant is not a controlled substance and has a lower risk of these issues.
Melatonin Receptor Agonists
Melatonin receptor agonists, such as ramelteon, interact with melatonin receptors in the body to promote sleep. While melatonin supplements are available over the counter, ramelteon is a prescription medication specifically indicated for insomnia characterized by difficulty falling asleep. It is important to note that melatonin is most effective for shifting sleep schedules rather than as a nightly sleep aid.
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Herbal supplements
Lavender essential oil is another popular herbal supplement for sleep. It can be found in products like lotions, bath salts, and sheet sprays. While there is no established physiological effect on the sleep system, the psychological effect of relaxation can help prepare the body for sleep. Herbal teas, such as chamomile, passionflower, and valerian, are also commonly used to promote sleep. Chamomile, in particular, is believed to interact with benzodiazepine receptors in the brain involved in the sleep-wake transition. However, the Natural Medicines Comprehensive Database states that there is insufficient evidence to prove its effectiveness in treating insomnia.
Some people also find relief in drinking warm milk before bed. It is thought to contain chemicals that mimic the effects of tryptophan, a building block for serotonin, which plays a role in the sleep-wake transition. Similarly, tart cherry juice is recommended by some experts for its potential sleep benefits.
Melatonin is a natural hormone that signals the timing of sleep. It is triggered by reduced light exposure and can be taken as a supplement to help adjust the sleep schedule, such as when travelling across time zones. Melatonin supplements are available over the counter, but they are unregulated, and dosages may vary across manufacturers. While they can help with jet lag and sleep enhancement, they are not recommended for regular use. Some people experience grogginess and depression, and there is a lack of research on their long-term effects.
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Side effects of sleep aids
While sleep aids can be effective in helping you fall asleep, they can also have side effects that range from mild to severe. It is important to be aware of these side effects before taking any sleep aid, whether it is a natural supplement, over-the-counter medication, or prescription drug.
Natural sleep aids, such as melatonin and valerian, are generally considered safe but can still cause side effects in some people. Melatonin, for example, is a hormone that regulates sleep-wake cycles, and while it can be helpful for shifting your sleep schedule (such as when travelling across time zones), it is not meant to be a long-term solution for insomnia or other sleep problems. Additionally, since melatonin is classified as a dietary supplement, it is not regulated as strictly as medications, and the amount of the substance in a product may vary.
Over-the-counter sleep aids, including antihistamines such as diphenhydramine (Benadryl) and doxylamine, can cause drowsiness, dizziness, and balance problems. These effects can last into the next day, impacting your ability to drive, work, or perform other daily tasks. This "hangover effect" is reported by approximately 8 out of 10 people who take sleep medicine. Over-the-counter sleep aids can also cause digestive problems, including constipation, diarrhea, gas, heartburn, and nausea.
Prescription sleeping pills are stronger than over-the-counter options and are typically not recommended for long-term use due to the risk of dependence and addiction. They can cause similar side effects to over-the-counter sleep aids, including constipation, muscle weakness, and digestive issues. Additionally, they may worsen snoring and sleep apnea. When discontinuing prescription sleep aids, rebound insomnia may occur, where your insomnia comes back worse than before.
It is always important to speak with a healthcare professional before taking any sleep aid, whether it is a natural supplement, over-the-counter, or prescription medication. They can help you understand the potential side effects and ensure that the sleep aid is safe for you based on your individual health history and needs.
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Frequently asked questions
Natural sleep aids are over-the-counter supplements that are intended to help you fall asleep faster or stay asleep throughout the night. Some natural sleep aids include melatonin, valerian root, lavender essential oil, herbal tea, and antihistamines like Benadryl.
Most sleep aids work by producing a sedative effect that makes you feel sleepy. They work on your brain receptors to slow down the nervous system, which reduces your breathing and heart rate. Some sleep aids cause drowsiness, while others silence the area of your brain that keeps you alert.
Sleep aids are generally safe to use for short-term sleep problems as long as you take them as recommended. However, it's important to talk to a doctor before taking any sleep aid to ensure it's safe for you and won't interfere with any medications or health conditions. Sleep aids can have side effects, including constipation, muscle weakness, and a "hangover effect" the next day, which can impact your ability to drive or work.
