Sleepless nights can seem like the longest nights of your life. Luckily, sleep aids can often help you catch some Zzz’s.
Insomnia refers to difficulty falling asleep, staying asleep or a lack of quality sleep. It can occur for a short period of time often due to mental or physical stress or chronically, for longer periods (greater than six months). People who are sleep deprived have an increased risk of motor or other accidents as well as other health conditions. Lack of sleep can cause general health disturbances and is linked with many chronic diseases. In fact, insomnia is one of the most common reasons people seek medical advice. Here are a few pointers to help you sleep better.
- The ability to fall and/or stay asleep is influenced by a number of factors such as medical conditions, medications, social factors, and stress. Knowing and addressing these first is the key to treating insomnia.
- Lifestyle and/ or behavior changes should be attempted before taking any sleep medications and should be continued even with medications.
- Lifestyle changes include avoiding late day caffeine and naps, exercising earlier in the day and adding a stress reducing ritual such as yoga before bedtime. Also, be sure to follow a routine sleep schedule and create a more peaceful sleep environment which includes minimizing light emitting devices such as tv and smartphones use before bed.
If sleepless nights continue, you may then consider using an over the counter (OTC) sleep aid to help with insomnia.
- For occasional sleeplessness, short term use (ideally less than 2 weeks) of an over the counter sleep aid may help provide enough rest required to combat insomnia.
- Over the counter medicines are still medicines. They can have side effects and may interact with other medicines you take. Check with your pharmacist or provider before taking one.
- Most of these sleep aids are not meant to be taken in the middle of the night if you wake up. Best results occur when they are taken about 30 minutes before your desired bedtime to minimize the next day drowsiness and “hangover” effect.
- Anyone under 16 years of age should consult with a doctor before taking any over the counter sleep aids.
Common sleep aids
| Type | How it works | Side effects |
| Diphenhydramine Benadryl, “PM” products like Tylenol PM, Advil PM, etc. | Antihistamine that causes drowsiness | “Hangover” effect of daytime drowsiness, dry mouth, blurry vision, bladder effects |
| Doxylamine Unisom | Antihistamine that causes drowsiness | “Hangover” effect of daytime drowsiness, dry mouth, blurry vision, bladder effects |
| Melatonin | Hormone that helps control sleep-wake cycle | Mild daytime drowsiness, headache |
| Valerian | Plant-derived sleep aid | Dizziness, headache, digestive/ stomach effects |
In certain cases, such as chronic insomnia, your provider may decide a prescription sleep aid is needed. Prescription sleep aids may include medicines that also have antidepressant effects, anti-anxiety effects or act as pain relievers. Examples include trazodone, mirtazapine, lorazepam, zolpidem (Ambien®), or Belsomra®. Keep in mind:
- Your age, other medical conditions, side effects, and cost may be considered before selecting one.
- It may take a trial of more than one medication (one at a time) before finding one that works best.
- Evaluation of whether the sleep medication is necessary should occur on a periodic basis to reduce risk of dependency and minimize side effects. Approximately 75% of people with insomnia report improved symptoms within one year.
The reduced amount and/or quality of sleep that occurs with insomnia can greatly affect your general health and well-being. Changes in your lifestyle, behavior and in some cases medications can help promote better sleep until your insomnia improves. Talk to your pharmacist or provider to discuss the best options to help you get some of those much needed ZZZZZZZs.
Sources:
https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep-aids/art-20047860, Accessed September 4, 2018.
Bonnet MH, et al. Behavioral and pharmacologic therapies for chronic insomnia in adults. https://www.uptodate.com/contents/behavioral-and-pharmacologic-therapies-for-chronic-insomnia-in-adults, Accessed September 4, 2018.
CDC. Sleep and sleep disorders. https://www.cdc.gov/sleep/index.html, accessed Sept 4, 2018 https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html
Comparison of Insomnia Treatments. Pharmacist Letter. January 2015. https://pharmacist.therapeuticresearch.com/Content/Segments/PRL/2014/Jul/Comparison-of-Insomnia-Treatments-7197, accessed September 4, 2018.
