Sleep Aids: The Ultimate Guide

If you have trouble falling asleep at night or staying asleep through the night, a sleep aid can help you get some shuteye.

There are lots of sleep aids available today, from prescription medication to over-the-counter aids and herbal remedies. You can also turn to relaxation strategies, such as meditation or mindfulness, as a type of sleep aid. 

These days, sleep aids are more popular than ever. According to the American Sleep Association, the over-the-counter sleep aid market makes more than $400 million annually in the U.S. On a global scale, the market for sleeping aids is valued at an estimated $64 billion and is expected to continue growing.

In 2020 alone, 8.4% of adults reported in a survey that took sleep medication in the last 30 days. The use of medication generally increased with age, and women (10.2%) were much more likely than men (6.6%) to take medication for sleep.

So, why exactly are sleep aids so commonly used? Recent data from the CDC shows that 14.5% of adults have trouble falling asleep, while 17.8% percent of adults have trouble staying asleep — a struggle that increases with age.

If you fall into either of these groups, you may be wondering exactly how different sleep aids work and how to determine which might be right for you.

To help you make an informed decision, we’ll dive into three categories of sleep aids and how to use them safely. We’ll also share potential side effects and healthy habits you can try (like making sure you have a comfortable mattress) before turning to sleep aids if you’re having trouble sleeping.

Types of Sleep Aids

Sleep aids come in many different forms. The three most common types of sleep aids are prescription sleep aids, over-the-counter sleep aids and herbal or natural sleep aids. Here’s everything you should know about each type.

Prescription Sleep Aids

Prescription sleep aids are the most common treatment of choice for people with severe insomnia who have tried lifestyle changes and/or cognitive behavioral therapy (CBT) to improve their sleep without any results. Typically, prescription sleep aids or medication is a last-resort that doctors prescribe to patients after any possible underlying health conditions that could be contributing to ongoing sleep issues are ruled out.

Prescription sleeping pills are stronger than over-the-counter sleep aids and can help you fall asleep more quickly, remain asleep or sleep for longer. While there are numerous FDA-approved prescription sleep aids, here are two of the most common that you may encounter if you struggle with insomnia.

• Eszopiclone, brand name Lunesta. Eszopiclone is a hypnotic, a type of drug that slows 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. It comes with a number of potential side effects, such as 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 a benzodiazepine, a type of drug that slows down brain activity to induce sleep. This medicine comes in pill form and is taken at bedtime. Potential estazolam side effects can include grogginess, feeling drowsy, feeling weak, dizziness, constipation, agitation, aggression, muscle stiffness and leg pain. If you have any issues when taking this medication, talk to your doctor.

Benefits of Prescription Sleep Aids:

• They have been rigorously tested by the Food and Drug Administration (FDA). Each prescription sleep aid is backed by extensive research that proves its benefits as a sleep remedy.
• Ongoing studies aim to reduce the side effects of these drugs.
• Depending on your coverage plan, your health insurance may cover some or all of the costs of prescription sleep aids.
• If a brand-name medication is too expensive, many prescription sleep aids come in more affordable generic forms.

Downsides to Prescription Sleep Aids:

• A prescription from a medical doctor is required to get prescription sleep aids. If you lack access to medical care or a physician doesn’t believe sleeping pills are right for your diagnosis, you likely won’t be able to get a prescription for a sleep aid.
• Some prescription sleep aids come with a risk of drug abuse or drug dependence and are habit-forming. It’s possible to build up a tolerance to prescription sleep aids, which may 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, be sure to speak with your doctor to develop a plan together.
• Ongoing research shows that long-term prescription sleep aid use can come with increased risk for cancer, mortality and dementia.
• As with any prescription medication, sleep aids can cause side effects. Side effects vary depending on which medicine you use, but common ones include dizziness, nausea and diarrhea. There is also a risk in some individuals for a severe reaction to sleep aids, such as an allergic reaction or life-threatening anaphylaxis.
• In recent years, the FDA issued new warnings for prescription sleep aids since they can cause residual drowsiness the day after use. Be sure to use caution when driving or operating machinery.

Over-the-Counter Sleep Aids

Over-the-counter (OTC) sleep aids are medications for sleep that you can purchase on your own without a prescription, such as at a local drug store. 

The majority of over-the-counter sleep aids contain antihistamines, which can have a sedating effect that can ultimately help you fall or stay asleep. Still, like prescription sleep aids, you can build up a tolerance to these medications.

“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.”

While there are numerous over-the-counter sleep aids available today, one of the most popular choices for a sleep remedy is diphenhydramine, brand name Benadryl. This medication is commonly used to treat symptoms of allergies, but as an antihistamine, Benadryl has the power to make you drowsy.

A second popular OTC sleep aid is doxylamine succinate, brand name Unisom SleepTabs. This sleep medication also falls into the antihistamine class, but it’s important to remember that non-prescription sleep aids should only be used as a temporary solution and not as a long-term sleep remedy. 

Common uses for over-the-counter sleep aids include combating jet lag or alleviating a brief bout of sleeplessness (such as during a very busy week).Ideally, you should take an over-the-counter sleep aid two or three nights at a time to help prevent tolerance to the sedating effects of these medications.

“Tolerance to the sedative effects of antihistamines can develop quickly,” Mayo 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:

• OTC sleep aids are much more accessible than prescription sleep aids. You can buy them without a prescription or official diagnosis.
  They can be found almost anywhere. OTC sleep aids are sold at drugstores, gas stations, airports, grocery stores and even online.

Downsides to OTC Sleep Aids:

• Since OTC sleep aids aren’t covered by health insurance, they can easily get expensive if you take them on a regular basis.
• You might feel tired or groggy the day after taking them.
• Regular use may put you at an increased risk for stroke.
• It’s easy to develop a tolerance to OTC sleep aids.
• 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 it’s important to do your research on potential interactions with any medications or supplements you are taking.

Natural Sleep Aids

A third major category of sleep aids is herbal and natural remedies, which is a growing movement as people look for more natural solutions to sleep loss.

You can find a wide range of natural sleep aids that come in various forms such as OTC supplements, tinctures, teas, gummies and even cannabis. However, be wary of overly-promising marketing claims on some of these products, and be sure to do your research before using a natural sleep aid.

That being said, here are five evidence-backed natural sleep aids:

• Valerian. Valerian is a tall, flowering grassland plant that’s been used as a natural sleep aid since ancient times, but only its root is used for sleep purposes. Studies show that valerian, which comes in capsule and tincture form, can be a safe and effective way to promote sleep and even prevent sleep disorders. Other research shows that valerian, which is used to induce sleep and improve sleep quality, can have both sedating and anti-anxiety effects. While valerian has minimal side effects, it can potentially cause headache, upset stomach or drowsiness. You can also find valerian root as a main ingredient in anti-energy drinks, which are beverages that help promote relaxation and sedation.
  
• Melatonin. As it gets dark outside, your body naturally produces a hormone called melatonin, which promotes sleepiness. That’s why many people turn to melatonin for jet lag support when traveling to different time zones. As one of the most extensively-studied natural sleep aids, many studies point to melatonin — which typically comes in capsule or pill form — as an effective way to improve sleep quality and synchronize your circadian rhythm, or your natural internal clock that regulates your sleep-wake cycle. While there is no official recommended dosage for melatonin, most melatonin supplements range from one to 10 milligrams. Like most natural sleep aids, melatonin should be used as a short-term solution, and it’s best to take melatonin every other day to help prevent tolerance. Side effects tend to be minor and include agitation, fatigue and mood swings.
  
• Chamomile tea. Some people swear by a hot cup of chamomile tea before bed to help them sleep. Data shows that chamomile can significantly improve sleep quality, and if you don’t want to drink tea before bed, you can also try a chamomile extract or supplement. Chamomile is also effective at reducing anxiety, which can contribute to serious sleep issues like insomnia.
  
• Cherry juice. One study found that drinking a small amount of tart cherry juice two times a day could help you sleep better. If you want to try this natural sleep aid, look for a 100% cherry juice with no added sweeteners, since increased sugar intake can negatively impact sleep, especially when consumed before bed.
  
• Magnesium. Magnesium is a popular relaxation supplement with many evidence-backed benefits for sleep, including improved quality and faster occurrence of sleep. Magnesium supplements come in many forms, including powders or drink mixes, capsules and tinctures. You can also raise your magnesium levels naturally by eating foods rich in magnesium such as whole grains, dark-green leafy vegetables and chocolate.
  
• Cannabis. As cannabis restrictions ease in many states, some people turn to legal recreational or medicinal cannabis as a natural sleep aid. While research in this often-controversial area is still ongoing, early data suggests that cannabis may be effective in treating sleep-related issues like sleep apnea and nightmares.

Benefits of Natural Sleep Aids:

• Natural sleep aids don’t require an official diagnosis or prescription to purchase and are available in many grocery stores or online. 
• 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. 
• Certain individuals may be more comfortable with using natural or herbal remedies over pharmaceutical sleep aids.
• They may not come with as many potential side effects as prescription sleep aids.

Downsides to Natural Sleep Aids:

• Many natural sleep supplements have not been tested for safety or efficacy by the FDA. This means they could be ineffective or even unsafe (which is why doing your homework matters).
• 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.
• Many natural sleep aids 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.

When Can You Use Sleep Aids

People turn to sleep aids to alleviate a variety of sleep-related problems. This can include overcoming jet lag, getting on a new sleep schedule (like when starting a new job) or for support during brief bouts of sleeplessness.

Most commonly, sleep aids are used to treat insomnia. Roughly one in three adults worldwide have insomnia symptoms, with 10% meeting the criteria for insomnia disorder. Insomnia is defined as having trouble sleeping at night, staying asleep or both. These are the 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)

When Should You Avoid Taking Sleep Aids?

Sleep aids aren’t for everyone, even if you have trouble sleeping. Since prescription, over-the-counter and natural sleep aids have the potential of interfering with other medications, it’s important to check with a physician before starting any sleep aid if you currently take medicine or supplements.

If you’re being treated for a health condition, be sure to check with your doctor about the benefits, risks and overall safety of starting a sleep aid, since some sleep aids can increase your risk for heart-related conditions.

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.

People who are pregnant or trying to become pregnant should also avoid starting a new sleep aid before first checking with their treating physician.

How Long Do Sleep Aids Last?

How long sleep aids work for or stay in your system can vary greatly with each type of sleep aid. Some sleep aids help induce feelings of drowsiness and leave your system in a very short period of time, from just 30 minutes to one hour. An examples of a sleep aid with a very short half-life is Zaleplon.

Others, like some prescription benzodiazepines, can stay in your system for up to 10 days. If you’re concerned about lingering effects of sleep aids, speak to your doctor to learn more about how long a sleep aid remains in your body.

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.

Plus, some people are just more sensitive than others to medications or supplements. Consider these safety issues before taking a sleep aid:

Sleep Aid Side Effects

All types of sleep aids (even natural ones) can cause potential side effects, although prescription sleeping pills carry the biggest risk. Not everyone will experience side effects from sleeping pills, but it’s important to know what to look for. These side effects can range from mild to severe to life-threatening.

Common side effects of prescription sleep medications include:

• Dizziness
• Diarrhea
• Feeling lightheaded
• Nausea
• Changes in appetite
• Daytime drowsiness
• Changes in behavior

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.

Avoiding a Sleep Aid Addiction

If you take prescription sleep aids for a long time, you might find it’s hard to stop taking them without rebound effects or even feeling sick, which are symptoms of temporary withdrawal. This is known as a dependency.

It’s important to never stop a prescription sleeping pill cold-turkey for this reason. If you want to stop taking a prescribed sleep aid, be sure to do so under the supervision of a medical professional and to slowly taper your dose.

To avoid a sleep aid addiction or dependency in the first place, only take your sleep aid as prescribed and try to steer clear of long-term use, if possible. In the event that you take a prescribed sleeping pill and still can’t sleep, be sure to avoid taking more, as this is how some sleep aid addictions begin.

In fact, research shows that taking some sleeping pills like benzodiazepines and Z-drugs for too long or in too high of a dose can lead to dependency.

How to Use Sleep Aids Safely

It’s wise to exercise caution with any type of sleep aid, whether it’s prescribed, over-the-counter, or a natural remedy. Here’s how to use sleep aids safely:

With all prescription sleep aids, be sure to follow your prescribing doctor’s advice, including when and how to take your sleeping pill. Never go above or beyond your recommended dose, as this can cause symptoms of withdrawal or dependency. Be sure to 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 have any concerns about dependency or feel like you’re growing dependent on a prescription sleep aid, speak to your doctor as soon as possible to develop a plan to safely wean you off of your medicine.

Those taking OTC sleep aids should carefully follow the instructions on the packaging for when and how to take that medication. Be sure to follow the recommended dose and seek medical help right away for severe side effects.

Natural remedies can be tricky to use safely and require some research on your end about both the brand you’re buying from and the type of sleep aid you’re considering. It’s important to purchase from reputable brands that disclose their ingredients, dosages and/or use third-party testing.

How to Get Better Sleep Naturally

There are many proven ways to get better sleep naturally without the help of sleep aids. Before turning to a prescription sleeping pill, OTC sleep medicine, or natural sleep remedy, be sure to try these healthy lifestyle changes first.

Practice Good Sleep Hygiene

It may come as a surprise, but sleep hygiene has nothing to do with keeping your sheets clean. Instead, sleep hygiene is an all-encompassing term for healthy behaviors, habits, and environmental factors that promote good sleep.

Here are easy sleep hygiene changes that you can make in your own home.

Create the Best Sleep Environment

Your sleep environment can make a big difference in the quality of your sleep. Light, noise, and even a bedroom that’s too hot can all affect how quickly you fall asleep (and your ability to stay asleep as well).

Keeping your bedroom as cool, dark, and quiet as possible can help you get quality shut-eye. If light or noise is interfering with your sleep, you can try blackout shades, fans, white noise machines, or even sleeping with earplugs or eye masks. Most experts also suggest setting your temperature anywhere from 60 and 67 degrees for the most comfortable sleeping condition.

Make a Zen Bedtime Routine

Getting into the habit of a consistent (and relaxing) bedtime routine can help you both fall and stay asleep. This includes steering clear of scrolling your phone before bed or using other devices that emit blue light, which can interfere with your melatonin production and ultimately keep you awake. 

Watching TV in bed can also have the same effect, so reading a book (an actual physical book, not an e-reader) may be a more relaxing choice.

In the event that you can’t sleep, meditation and progressive muscle relaxation, or gently tensing and relaxing your muscles, can help promote sleepiness. Gentle deep breathing is another way to relax your body.

Follow a Consistent Bedtime and Wake Up Time – Even on Weekends

Sticking to a regular sleep schedule can help your body learn when it’s time to go to bed and wake up. Research shows that consistent sleep routines result in greater quality sleep, so while it can be tempting to catch up on sleep and snooze until noon, it’s best to go to bed and get up at the same time every day.

Some people like to wake up with the sunrise, which is a practice used since ancient times. The early morning light has an energizing effect on the body, making it easier to complete various daytime tasks and activities (and, studies back up the benefits of early rising). A good sunrise alarm clock can help you wake up with the sun each morning.

Only Use Your Bed for Sleeping and Sex

While it can be tempting to work in bed, eat in bed, or watch TV in bed, most sleep experts agree that you should only use your bed for sleeping and sex. This helps your brain associate your bed with sleep. Having a high-quality mattress for sex and sleep can also make it easier to follow this guideline.

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