Sleep Aids: Your Guide to Medications and Supplements

Sleep has a multitude of benefits spanning physical health, well-being, and mood. While some people can drift off to sleep easily, as many as two-thirds of adults report having trouble sleeping and up to 15% have long-lasting symptoms of insomnia.

Whether sleep problems are infrequent or happening every night, the first step to getting better rest may be to improve your sleep habits or seek cognitive behavioral therapy for insomnia (CBT-I). When these approaches are not effective, many people benefit from short-term use of a sleep aid.

Over-the-counter, prescription, and natural sleep aids are all options that you may consider to alleviate sleep problems and help you get the quality rest you need. Before trying a sleep aid, it can be helpful to explore some of the most common options and learn about their respective risks and benefits.

Natural sleep aids are dietary supplements and herbal remedies that claim to improve sleep quality. While some people may choose natural sleep aids because they believe that natural medicine is the safest option, it’s important to keep in mind that these supplements can also have side effects.

It’s also important to know that natural sleep aids sold as dietary supplements are not regulated by the Food and Drug Administration (FDA). This means that there are no quality standards in place to ensure the dose and ingredients of supplements are as marketed.

Melatonin

Melatonin is a popular sleep aid that is sold over-the-counter as a dietary supplement. While most melatonin supplements are made synthetically, melatonin is actually a hormone that your body produces naturally. Melatonin promotes sleep, primarily due to its ability to influence when a person falls asleep and when they wake up.

Experts believe that melatonin is safe to use in most adults for short periods and may be safe for up to two years. Taking melatonin supplements can cause side effects like nausea, headaches, and dizziness. Because melatonin can make you sleepy, avoid driving or operating heavy machinery for at least 4 to 5 hours after taking a dose.

Though more studies are needed on the safety of melatonin during pregnancy, experts recommend that pregnant people and people breastfeeding avoid taking melatonin. Additional risks associated with taking melatonin include:

• Increased risk of seizures for people with seizure disorders
• Interactions with certain medications
• Worsening symptoms of depression

CBD

Cannabidol, commonly referred to as CBD, is a chemical derived from the cannabis plant. Although research into the effects of CBD on sleep is limited, CBD may cause drowsiness and may have a calming effect on the body in large doses.

When used for up to a few months, CBD is generally considered safe. In some people, CBD can cause side effects such as light-headedness, low blood pressure, and dry mouth. Emerging research suggests that for people with Parkinson’s disease, high doses of CBD may worsen tremors and movement. Pregnant people should avoid using CBD.

Chamomile

Chamomile is a plant that has long been valued for its medicinal uses. Supplements containing chamomile are often marketed for skin, stomach, and sleep-related problems. Few research studies have looked into the effects of chamomile on these various health conditions, but some have shown promising results for the use of chamomile to improve sleep quality.

It is generally safe to take small doses of chamomile, like those found in a cup of tea, for a short period of time. However, nausea, dizziness, and severe allergic reactions are side effects that some people face after consuming or coming in contact with chamomile products.

Hops

Hops are a widely used natural sleep aid that come from the flowering portion of the hop plant. Though hops may make some people feel drowsy, supplements containing hops are often combined with other herbs and there are few studies into the benefits of hops alone.

Since research on the full effects of hops is limited, experts recommend against its use in pregnant or breastfeeding individuals. Additionally, hops can cause side effects such as dizziness. If you are planning on going into surgery or are taking prescription drugs, speak with a doctor before using a hops supplement.

Valerian Root

Valerian is a dietary supplement made from the roots and stems of the valerian plant. Valerian is often marketed as a sleep aid and advertised as having a calming effect on the nervous system. Though more research is needed to fully understand the potential uses of valerian, several studies have found that the supplement may benefit people with insomnia.

Few side effects of valerian have been reported in research studies, but some people may experience dizziness, headaches, or stomach problems after taking valerian. Pregnant people and young children should not take valerian without medical advice. Additionally, due to the potential for drug interactions, people taking sedatives or other medications should check with their doctor before taking valerian.

Magnesium

Magnesium is a nutrient that is naturally found in food and is involved in many bodily processes, including nerve function, blood pressure, and the regulation of sleep. It is sold as a dietary supplement and sometimes marketed as a sleep aid.

Although magnesium holds promise as a potential sleep aid, experts caution that more high-quality studies are needed to understand the relationship between sleep and magnesium.

Taking high doses of magnesium supplements can be dangerous. Exceeding the recommended daily limit of magnesium can lead to diarrhea, nausea, stomach cramps, and heart problems. Magnesium supplements can also interact with other drugs and change how they work in your body. The safest way to get magnesium is by eating a diet filled with magnesium-rich foods.

Over-the-counter sleep aids are medications that you do not need a doctor’s prescription to purchase. According to the FDA, over-the-counter medications are considered safe and effective if you follow the directions on the label and use them under the supervision of your doctor.

Most over-the-counter sleep aids contain antihistamines, which are often used in nighttime cold and sinus medicines marketed to promote sleep. These medications work by blocking histamines, which are substances in the body that cause alertness. Some people choose to use these medications because they are easy to find and relatively safe.

• Diphenhydramine: The most common ingredient in over-the-counter sleep aids is diphenhydramine. Although many people find that this medication makes them feel sleepy, it’s not recommended for long-term use.
• Doxylamine: Doxylamine is another antihistamine used in over-the-counter sleep aids. Although doxylamine may make people feel drowsy, very little research has been conducted related to its efficacy for sleep issues.

Experts caution against using antihistamines regularly to improve sleep. Antihistamines often lose their effectiveness with continued use and may cause side effects. Side effects of antihistamines include sleepiness after waking up, dry mouth, dizziness, and changes in vision and mood.

Prescription sleep medications are regulated by the FDA and can only be purchased at a pharmacy with a prescription from a health care provider. The most common types of prescription medications for insomnia are benzodiazepines and z-drugs, though there are other types of drugs that are also used to treat insomnia.

• Benzodiazepines: These prescription medications work by stimulating GABA, a chemical in the brain, to induce sedation, relax muscles, and reduce anxiety. Doctors warn about long-term use of benzodiazepines and these medications have a high risk of being abused and may begin to reduce sleep quality over time.
• Z-drugs: Several prescription medications for insomnia are classified as z-drugs. These drugs are considered effective for treating sleep problems and improving the time it takes to fall asleep. However, side effects can include memory loss, disinhibition, stomach problems, and hallucinations.

Cognitive behavioral therapy for insomnia (CBT-I) is a drug-free method used to manage chronic sleep issues, targeting the emotional and behavioral patterns that lead to disrupted sleep. Regarded by some medical professionals as the most effective treatment for persistent insomnia, CBT-I is conducted by a trained sleep therapist and includes multiple individual or group sessions.

During CBT-I, a therapist helps patients identify and change unhealthy habits that lead to poor sleep. A sleep diary is commonly used to gather an overview of sleep patterns, and recommendations for healthy lifestyle modifications are made based on a patient’s unique needs. A CBT-I therapist will use a multi-pronged approach to help patients eliminate unhealthy thought patterns, reduce sleep-related anxiety, and incorporate good sleep hygiene practices into their daily routine.