Evie Summers
Sleep is an essential part of our lives, and for those who struggle with it, there are a variety of medications that can help. Sleeping pills are available over the counter or by prescription, and natural sleep aids like melatonin and valerian can also help promote sleep. Prescription medications such as benzodiazepines, zolpidem, and eszopiclone are also options for those seeking a good night's rest. However, it is important to note that sleeping pills can have side effects and are typically recommended for short-term use only.
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What You'll Learn
Melatonin supplements
Melatonin is a hormone that is produced naturally in the brain to help regulate the body's sleep cycle. Melatonin supplements are available over the counter and can be used to aid sleep. They are often used by people experiencing insomnia or jet lag, or those who need to adjust their sleep schedule. Melatonin supplements have been found to help people fall asleep faster and improve sleep quality, duration, and consistency.
It is recommended that you take 1 to 3 milligrams of melatonin two to three hours before your desired bedtime. You should only take melatonin supplements nightly for one to two months. If they are helping you, you can stop taking them and observe how your sleep is. If melatonin is not helping you sleep after one to two weeks, you should discontinue use. Melatonin supplements are generally safe for short-term use, but they may cause side effects such as drowsiness, headaches, and vivid dreams.
To maximize the effects of melatonin, it is recommended to create optimal conditions for sleep by keeping lights low before bed and limiting screen time, especially blue light, which can interfere with melatonin's effects. Exposure to daylight during the morning and afternoon can also help program your body to produce melatonin at the right time of day.
It is important to note that melatonin supplements are not approved by the U.S. Food and Drug Administration, so they may include additional ingredients that are not safe. Additionally, melatonin supplements should not be used as a replacement for good sleep practices. Most physicians recommend committing to good sleep practices before taking melatonin supplements.
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Prescription sleeping pills
Sleeping pills are available over the counter, as natural supplements, or by prescription. Prescription sleeping pills are stronger than over-the-counter ones and are only recommended for short-term relief. They are not a cure for insomnia, and there is a risk of dependence and addiction.
Some common prescription sleeping pills include antidepressants, barbiturates, and benzodiazepines (benzos). Benzodiazepines work by stimulating a chemical in the brain called GABA, which leads to sedation, muscle relaxation, and reduced anxiety. Examples of benzodiazepines include quetiapine (Seroquel), olanzapine (Zyprexa), and risperidone (Risperdal). These medications are classified as Schedule IV controlled substances due to their potential for abuse, addiction, and dependence. They are generally recommended for short-term use only.
Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta), are also prescription-only sleep aids. Similar to benzodiazepines, they interact with GABA receptors in the brain, causing sedation and reduced anxiety. Zaleplon (Sonata) is another Z-drug, but it is not approved for long-term use. Ramelteon (Rozerem) is the only FDA-approved, prescription melatonin receptor agonist for treating insomnia. It is not a controlled substance as it has not shown potential for misuse and addiction.
Other prescription sleeping pills include suvorexant (Belsomra), lemborexant (Dayvigo), and daridorexant (Quviviq). These medications have been FDA-approved for treating insomnia characterized by trouble falling and staying asleep. They work by blocking orexin receptors in the brain, which are thought to be involved in wakefulness. Doxepin (Silenor) is a tricyclic antidepressant that is also FDA-approved for treating insomnia characterized by difficulty staying asleep. It is not a controlled substance, but it is only available with a prescription.
It is important to note that sleeping pills, including prescription ones, can cause various side effects, such as constipation, muscle weakness, and daytime drowsiness. 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. Therefore, it is recommended to consult a healthcare provider before taking any sleep aids, as they can determine the underlying cause of insomnia and suggest the most appropriate treatment plan.
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Natural sleep aids
While prescription and over-the-counter sleep medications are available, natural sleep aids are a popular alternative. These are classified as dietary supplements and are not as strictly regulated as medications. It's important to consult a healthcare professional before taking any sleep aid, as they may interfere with other medications or cause side effects.
One well-known natural sleep aid is melatonin, a hormone that the body produces naturally in response to reduced light exposure. Melatonin supplements have become a popular way to promote sleep, as they can reduce the time it takes to fall asleep and improve overall sleep quality. However, they may not be suitable for everyone, and it's important to be cautious as they are not regulated.
Another natural sleep aid is valerian, an herbal remedy made from the roots and stems of the valerian plant. It is believed to aid relaxation and sleep by having a calming effect on the nervous system. Limited evidence suggests that taking 300 to 600 milligrams of valerian before bed can help people fall asleep and improve sleep quality. However, it can cause morning drowsiness, and some people may experience the opposite effect, leading to sleeplessness.
Other natural sleep aids include magnesium, lavender, chamomile tea, and tart cherry juice. Even natural sleep aids should be used in conjunction with good sleep practices and habits, such as avoiding screen time and late-night workouts.
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Over-the-counter sleep aids
Diphenhydramine and doxylamine succinate are common sedating antihistamines found in many over-the-counter sleep aids. By reducing histamine levels in the brain, they help induce sleepiness. However, it is important to note that these medications are intended for occasional use and should not be relied upon long-term. Natural sleep aids like melatonin work differently from antihistamines. Instead of directly causing sleepiness, they support the body's natural sleep-wake cycle by promoting the production of melatonin, which helps regulate sleep. Valerian, another natural option, has a calming effect on the nervous system, aiding in relaxation and sleep.
It is crucial to remember that over-the-counter sleep aids are not a long-term solution for insomnia or other sleep disorders. Consistent sleep difficulties may require cognitive behavioural therapy or other non-drug therapies to address the underlying causes. Additionally, forming good sleep habits, or "sleep hygiene," is essential for maintaining healthy sleep patterns. This includes practices such as maintaining a consistent bedtime, keeping the bedroom temperature cool, avoiding screens before bedtime, and creating a relaxing sleep environment.
While over-the-counter sleep aids can provide temporary relief for occasional sleeplessness, they should be used cautiously and in consultation with a healthcare provider. It is important to be aware of potential side effects, drug interactions, and the possibility of dependency. For long-term sleep problems, it is advisable to seek professional advice and explore alternative treatments or lifestyle changes that can improve sleep quality and duration.
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Non-drug therapies
While pharmacotherapy is the most common treatment for insomnia, non-pharmacological options provide longer-lasting benefits. Behavioural interventions are an important aspect of treating chronic primary insomnia and can produce improvements in sleep parameters such as sleep onset latency, time awake after sleep onset, number of awakenings, and total sleep time.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is the most prominent non-pharmacological treatment for insomnia and is recommended as the first-line treatment for chronic insomnia in adults by the American Academy of Sleep Medicine. CBT targets behavioural, cognitive, and physiological factors that perpetuate insomnia and aims to modify and alter maladaptive behaviours and distorted beliefs about sleep and insomnia. CBT can be delivered in different formats, such as face-to-face individual or group therapy, or digitally delivered self-help. It has been shown to produce reliable and sustained improvements in sleep patterns, with benefits sustained 12 and 24 months later. CBT alone yields the greatest number of normal sleepers, with greater patient satisfaction than with pharmacotherapy.
Relaxation Therapy
Relaxation therapies are based on the premise that patients with insomnia display high levels of physiologic and cognitive arousal throughout the day and night. These therapies aim to deactivate this hyperarousal and can include progressive muscle relaxation, autogenic training, imagery training, and meditation. Most relaxation therapies can be self-administered by patients after initial professional guidance and regular practice over several weeks.
Sleep Hygiene Education
Sleep hygiene education teaches patients about good sleep habits and helps them to associate the bedroom with sleep and sex only, and not other wakeful activities. This can include following instructions such as not napping and remaining awake for as long as possible.
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Frequently asked questions
OTC sleep aids often contain antihistamines, which can make you feel drowsy. Some natural remedies include melatonin and valerian root supplements, which promote sleep and aid relaxation, respectively. However, it is always best to consult your healthcare provider before taking any new medication or supplement.
Doctors may prescribe medications such as zolpidem, triazolam, temazepam, or eszopiclone for short-term insomnia relief, typically for 7 to 10 days. Doxepin, or Silenor, is another option that may be prescribed for up to 3 months. These medications can cause side effects and have the potential for dependency, so they are not recommended for long-term use.
Yes, non-drug therapies such as cognitive behavioral therapy (CBT) may be more effective in improving your sleep. Additionally, good sleep practices and behavioral changes can enhance the effectiveness of sleep medications.
