If you have a lot of trouble falling asleep at night or staying asleep through the night, maybe you’ve thought about using a sleep aid.
The term “sleep aids” refers to many different things, from prescription medication to over-the-counter aids and herbal remedies. Some people even describe behavioral options, such as meditation, as a sleep aid.
The American Sleep Association notes that the over-the-counter sleep aid market makes over $400 million annually in the U.S., meaning plenty of people are buying and using them.
As for prescription sleep aids, an American Academy of Sleep Medicine study from 2013 found that:
- 4.1% of U.S. adults aged 20 or older had taken a prescription sleep aid in the past month
- This rate was lowest among adults aged 20 to 39 (1.8%)
- This rate was highest among adults aged 80 or older (7%)
- Women were more likely to use prescription sleep aids than men
This piece will review different categories of sleep aids and explain how they work. It will also cover how to use sleep aids safely, what side effects to look out for, and healthy habits you can try (like making sure you have a comfortable mattress) before turning to sleep aids if you are not getting enough sleep at night.
What Are The Different Types Of Sleep Aids?
There are a variety of sleep aids on the market. Three common categories of sleep aids are prescription sleep aids, over-the-counter sleep aids, and herbal or “natural” sleep remedies. Let’s take a closer look at each of these categories.
Prescription Sleep Aids
According to the Mayo Clinic, prescription sleeping pills can help you fall asleep more quickly, remain asleep, and/or sleep for longer.
Doctors can prescribe them for people suffering from severe insomnia, though the clinic says most physicians will first recommend lifestyle changes and cognitive behavioral therapy (CBT). Prescription medication is generally thought of as a last resort.
Here are two of the most common prescription sleep aids:
- Eszopiclone, brand name Lunesta. MedLine Plus explains that eszopiclone is a type of drug called a hypnotic, and it works by slowing down brain activity to help you fall asleep and stay asleep. Eszopiclone is a pill that people take at bedtime or after they have been lying awake for a while. There are a number of potential side effects, including dizziness, headaches, nausea, vomiting, heartburn, dry mouth, unusual dreams, and feeling drowsy during the day. If you experience side effects that don’t subside, speak to your doctor.
- Estazolam, brand name ProSom. Estazolam is one of a class of drugs called benzodiazepines, and it also works by slowing down brain activity to induce sleep. The medicine comes in pill form, to be taken at bedtime. Potential estazolam side effects include grogginess, feeling drowsy, feeling weak, dizziness, constipation, agitation, aggression, muscle stiffness, and leg pain. If you have any issues when taking this medication, speak to your doctor.
Benefits Of Prescription Sleep Aids:
- They have been rigorously tested by the Food and Drug Administration (FDA). There’s at least some scientific proof that they treat what they are prescribed for.
- Health insurance may cover some or all of the costs of prescription sleep aids, depending on your coverage plan.
- Many prescription sleep aids are available as generic drugs, which can be cheaper than brand-name medications.
Downsides Of Prescription Sleep Aids:
- You need a prescription from a medical doctor to obtain these sleep aids. That means they are inaccessible if you don’t have access to medical care, and it also means doctors can deny you a prescription if they do not believe you have a relevant diagnosis.
- Some prescription sleep aids have a higher potential than others for drug abuse or drug dependence. According to Addiction Center, people may build a tolerance to prescription sleep aids so they require a higher and higher dosage to see any effect. “A lot of people don’t realize they’ve become dependent, or possibly addicted, until they stop taking their sleeping medication,” Addiction Center explains. “All of a sudden they begin experiencing withdrawal symptoms, a telltale sign of both dependence and addiction.” If you have any concerns about becoming dependent on prescription sleep aids, speak with your doctor and you can make a plan together.
- As with any prescription medication, sleep aids can cause side effects in some people. Side effects vary depending on the medicine, but common ones include dizziness, nausea, and diarrhea. Some people may have severe reactions to sleep aids, such as an allergic reaction or life-threatening anaphylaxis.
- Earlier this year, the FDA issued new warnings for prescription sleep aids on the grounds that they may provoke dangerous behaviors stemming from residual drowsiness the day after their use.
Over-The-Counter Sleep Aids
According to Harvard Health, most over-the-counter (OTC) sleep aids are antihistamines with a sedative effect.
“Tolerance to the sedative effects of antihistamines can develop quickly — so the longer you take them, the less likely they are to make you sleepy,” Harvard Health explains. “In addition, some over-the-counter sleep aids can leave you feeling groggy and unwell the next day. This is the so-called hangover effect.”
One popular OTC sleep aid is diphenhydramine, brand name Benadryl. A second popular OTC sleep aid is doxylamine succinate, brand name Unisom SleepTabs. Both medications are antihistamines, which the Mayo Clinic says you should only use for sleep issues for two or three nights at a time and not long term.
“Tolerance to the sedative effects of antihistamines can develop quickly,” the clinic explains. “As a result, the longer you take them, the less likely they are to make you sleepy. Side effects might include daytime drowsiness, dry mouth and dizziness.”
Benefits Of OTC Sleep Aids:
- You don’t need a prescription to access them, meaning you don’t need to go to a doctor’s appointment, receive an official diagnosis, receive a prescription, and then go pick up that prescription.
- They are easy to access. They’re typically available at any drugstore, many gas stations, and some airports if you are traveling.
Downsides Of OTC Sleep Aids:
- OTC sleep aids are not covered by health insurance and can get quite expensive if you take them regularly.
- They can make you feel tired and groggy the next day.
- You can develop an increased tolerance to OTC sleep aids quite quickly if you take them often.
- If you have a diagnosed sleep disorder, such as insomnia, an OTC sleep aid might not be the most effective treatment.
- OTC sleep aids don’t require the oversight of a doctor, so you might accidentally take an OTC pill that interacts with other medications or supplements you are taking.
Herbal And “Natural” Remedies
These can come in the form of OTC supplements, teas, gummies, and more. If you are thinking about a branded herbal supplement, don’t take at face value what the company says the supplement can do.
While prescription medications must be evaluated, tested, and approved by the FDA, so-called dietary supplements are not subjected to that same testing. So it’s important to research what has been scientifically proven about the key ingredients in a supplement using a reliable source such as The Office of Dietary Supplements (ODS) and/or The National Center for Complementary and Integrative Health (NCCIH).
With that caveat, here are a few supplements that do have some scientific backing:
- Valerian. “Results from multiple studies indicate that valerian — a tall, flowering grassland plant — may reduce the amount of time it takes to fall asleep and help you sleep better,” the Mayo Clinic says. “Of the many valerian species, only the carefully processed roots of the Valeriana officinalis have been widely studied. However, not all studies have shown valerian to be effective, and there may be some dangers.”
- Melatonin. Your body naturally produces a hormone called melatonin, which helps cue your body that it’s time to go to sleep each night. If you aren’t sleeping well, Dr. Anil Rama, an adjunct clinical faculty at the Stanford University Sleep Center, says “you can consider taking melatonin supplements in physiologic dosages (300 mcg) versus pharmacologic dosages (3 to 10 mg) when the sun sets, which is when the body would naturally produces melatonin. “Research suggests that melatonin might provide relief from the inability to fall asleep and stay asleep (insomnia) by slightly improving your total sleep time, sleep quality and how long it takes you to fall asleep,” the Mayo Clinic says. “Evidence shows that melatonin can modestly improve jet lag symptoms, such as alertness.
- Some people swear by a cup of chamomile tea before bed to help them sleep. Scientific research on the sleep-promoting effects of chamomile is limited, but some people may find that sipping tea soothes them and helps them wind down at night.
The Benefits Of “Natural” Sleep Aids:
- You do not need an official diagnosis or a prescription to purchase natural sleep aids.
- Some natural sleep aids come in the form of tea, which can be a more pleasant experience to take than a pill or liquid medication. Also, sipping a cup of tea before bed can be part of a helpful wind-down routine.
- Some people are more comfortable with the idea of herbal remedies instead of pharmaceutical options.
- They may not come with as many potential side effects as prescription sleep aids.
The Downsides Of “Natural” Sleep Aids:
- Many sleep supplements available online and at drug stores have not been tested for safety or efficacy by the FDA. This means they could be ineffective or even unsafe.
- They are not subjected to the same labeling and marketing guidelines as prescription medications. This means they could contain unlabeled ingredients, different amounts of ingredients than what is listed on the label, or have ingredients missing. It also means they do not necessarily live up to what the marketing says they do.
- Many natural sleep supplements have not been tested on humans, but rather rely on results of studies done on rodents or isolated cells.
- They may not be covered by health insurance.
Why Do People Use Sleep Aids?
People typically use sleep aids if they are suffering from some kind of problem with their sleep. The most common use for a sleep aid would be for insomnia. People may also look for sleep aids to help them overcome jet lag.
Insomnia, defined by the University of Rochester Medical Center as “having trouble sleeping at night, staying asleep, or both,” is a very common sleep disorder. The Cleveland Clinic estimates that around 50 percent of adults will have short-term (acute) insomnia at some point, lasting for a few days at a time. Roughly 1 in 10 adults will experience long-term (chronic) insomnia lasting for weeks or months.
The Cleveland Clinic also explains that there are two major forms of insomnia:
- Primary insomnia is when your only symptoms are the symptoms of insomnia, i.e. trouble falling asleep and/or staying asleep through the night
- Secondary insomnia is when you have another health condition or problem that is causing your sleep trouble, like heartburn, arthritis, or asthma. Secondary insomnia can also be caused by medications or substance use (e.g. alcohol)
Are Sleep Aids Safe?
The safety of sleep aids depends on what type of aid you are using, what dosage you are taking, how long you are taking it for, how it affects you, and whether it interacts with other medications or supplements that you’re taking.
Here are a few safety issues to consider when it comes to sleep aids:
If you take prescription sleep aids for a long time, you might find it’s hard to stop taking them.
“People develop a dependence on them,” sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School, said in an article for Harvard Health. “When you take them away, they get a temporary withdrawal reaction and can’t sleep. But they think it’s because they need the drug to sleep.”
Some people may experience side effects, particularly from prescription sleep medications. These side effects range from mild to severe to life-threatening.
Common side effects of prescription sleep meds include:
- Feeling lightheaded
Severe side effects include trouble breathing and doing things you don’t remember while you are asleep — such as leaving the house or even driving.
Some prescription and OTC sleep aids may interfere with other medications you are already taking — which is why it’s important to check with a physician before taking anything new, especially if you are already being treated for a health condition.
For example, Drugs.com estimates that estazolam (ProSom) interferes with 324 different drugs and says that the drug is not recommended for people with glaucoma, renal or liver disease, respiratory depression, seizures, and more.
How To Use Sleep Aids As Safely As Possible
With prescription sleep aids, the safest way to use them is under the advice of a doctor. Only take what has been prescribed to you at the prescribed dose. Never take more or less than your doctor recommended, and seek medical help right away if you experience any severe side effects or anything that mirrors anaphylaxis (e.g. struggling to breathe, your throat feeling like it’s closing up, or facial swelling and hives). If you are concerned that you may become dependent on a prescription sleep aid, talk to your physician right away so you can come up with a plan to safely wean you off of the medicine.
If you are taking OTC sleep aids, follow the instructions on the packaging. Again, do not take any more or less than the packaging recommends for your age, sex, or size. Seek medical help right away if you experience any severe side effects.
Natural remedies can be tricky to use safely, because we still don’t know what dosages are helpful versus potentially harmful. Never purchase supplements from a company you don’t trust, and always research to see if the active ingredients in a supplement can interact with any medications you are taking.
Healthy Habits That Can Help You Sleep Without Aids
Practicing good sleep hygiene — a set of habits that can optimize your sleep — can make a huge difference for some people. Common sleep hygiene recommendations include:
- Keeping your bedroom as cool, dark, and quiet as possible. If you are often disturbed by noise from elsewhere in the house or outside, consider using a white noise machine, turning on a fan to mask other sounds, or sleeping with earplugs. And if your bedroom regularly gets too bright, you can use blackout shades or an eye mask to keep it comfortably dark.
- Go to bed at the same time each night and wake up at the same time each morning — even on weekends. If you stick to a regular sleep/wake routine, it’s more likely that you will get enough sleep each night. Plus, your body will get used to the schedule and help cue when it’s time to go to sleep and wake up.
- Use a bedtime routine to wind down each night before getting into bed, so you can relax and cue your body that it’s time to sleep. Avoid electronics for an hour before bed, as the blue light they emit can interfere with your body’s production of melatonin, a sleep-promoting hormone. Instead, try relaxing activities like taking a hot shower, meditating, listening to music, or reading a book.
- Only use your bed for sleeping and sex. If you use it for other activities, such as working, you won’t associate the bed with rest.
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The Bottom Line On Sleep Aids
People take sleep aids for a variety of reasons, but the most common is trouble falling asleep or staying asleep.
There are three main groups of sleep aids: prescription medicines, OTC medicines, and herbal remedies. Each option has its benefits and downsides.
Prescription meds are effective, but can be addictive. OTC pills are easy to get, but might not really work. And natural remedies are a non-pharmaceutical option, but supplements are not regulated and there’s less scientific proof that they work on humans.
Before turning to sleep aids, you might want to try lifestyle changes. Cutting down on caffeine and alcohol; adopting a relaxing bedtime routine; keeping your bedroom cool, dark, and quiet; and avoiding screens before bedtime might improve your sleep.
If you have tried lifestyle changes and still battle insomnia, it’s worth speaking to a doctor to see what they recommend. Most doctors will try therapy first, then prescribe sleep aids if you are still not sleeping well.
- Are drugstore sleep aids safe? – Harvard Health
- Sleep aids: Understand over-the-counter options – Mayo Clinic
- In Search of a Safe Natural Sleep Aid
[Editor’s Note: The content provided on this site is for general informational purposes only. Any information provided is not a substitute for professional medical advice. We encourage you to consult with the appropriate health expert if you have concerns.]
Featured image: Fizkes/Shutterstock
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