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continued:

Sleep aids: Understand over-the-counter options

Sleep aids: The options

Over-the-counter sleep aids are available in nearly any pharmacy. Here's a listing of common choices and the potential side effects:

  • Diphenhydramine (Benadryl, Unisom sleep). Diphenhydramine is a sedating antihistamine. Side effects might include daytime drowsiness, dry mouth, dizziness and memory problems.
  • Doxylamine (Unisom SleepTabs). Doxylamine is also a sedating antihistamine. Side effects are similar to diphenhydramine, including daytime drowsiness, dry mouth, dizziness and memory problems.
  • Melatonin. The hormone melatonin helps control your natural sleep-wake cycle. Some research suggests that melatonin supplements might be helpful in treating jet lag or reducing the time it takes to fall asleep — although the effect is typically mild. The most common melatonin side effects include daytime sleepiness, dizziness and headaches. Other, less common melatonin side effects might include abdominal discomfort, mild anxiety, irritability, confusion and short-lasting feelings of depression.
  • Valerian. Supplements made from this plant might reduce the amount of time it takes to fall asleep as well as promote better sleep overall. However, the active ingredient isn't clear and potency can vary. Side effects of valerian supplements might include headache, abdominal discomfort, excitability or uneasiness, and heart disturbances.

Store brands containing the same active ingredients as brand-name sleep aids are commonly available. Store brands have the same risks and benefits as their brand-name counterparts, often at a more reasonable cost.

If you decide to use over-the-counter sleep aids

If you think you'd benefit from over-the-counter sleep aids, follow these steps:

  • Start with your doctor. You don't need your doctor's OK to take an over-the-counter sleep aid, but it's a good idea to check with him or her anyway. Your doctor can make sure the sleep aid won't interact with other medications or underlying conditions, as well as determine the best dosage.
  • Keep precautions in mind. Diphenhydramine and doxylamine aren't recommended for people who have closed-angle glaucoma, asthma, chronic obstructive pulmonary disease, severe liver disease or urinary retention — which can be preceded by a weak urine stream or trouble starting urination. In addition, most sleep aids aren't recommended for women who are pregnant or breast-feeding.
  • Take it one day at a time. Over-the-counter sleep aids are a temporary solution for insomnia. Generally, they're not intended to be used for longer than two weeks.
  • Avoid alcohol. Never mix alcohol and sleep aids. Alcohol can increase the sedative effects of the medication.
  • Beware of side effects. Don't drive or attempt other activities that require alertness while taking sleep aids.

Everyone benefits from a good night's sleep. If you continue to have trouble sleeping, consult your doctor for additional help. In addition to lifestyle changes, your doctor might recommend behavior therapy to help you learn new sleep habits and ways to make your sleeping environment more conducive to sleep. In some cases, short-term use of prescription sleep aids might be recommended as well.

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References
  1. Bonnet MH, et al. Treatment of insomnia. http://www.uptodate.com/index. Accessed Sept. 16, 2011.
  2. Zhang D, et al. Next-day residual sedative effect after nighttime administration of an over-the-counter antihistamine sleep aid, diphenhydramine, measured by positron emission tomography. Journal of Clinical Psychopharmacology. 2010;30:694.
  3. Melatonin. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Sept. 16, 2011.
  4. Valerian. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Sept. 16, 2011.
  5. Schutte-Rodin S, et al. Clinical guideline for the evaluation and management of chronic insomnia in adults. Journal of Clinical Sleep Medicine. 2008;4:487.
  6. Generic drugs: Questions and answers. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/ResourcesForYou/Consumers/QuestionsAnswers/ucm100100.htm. Accessed Sept. 19, 2011.
  7. Side effects of sleep drugs. U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107757.htm. Accessed Sept. 19, 2011.
  8. Krystal AD. Pharmacologic treatment: Other medications. In: Kryger MH, et al. Principles and Practice of Sleep Medicine. 5th ed. St. Louis, Mo.: Elsevier Saunders; 2011:916.
  9. Morin CM, et al. Insomnia: Nature, diagnosis, and treatment. In: Chokroverty S, et al. Handbook of Clinical Neurology. 3rd ed. Philadelphia, Pa.: Elsevier; 2011:723.
  10. Foral P, et al. Insomnia: A therapeutic review for pharmacists. The Consultant Pharmacist. 2011;26:332.
SL00016 Dec. 10, 2011

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