Q: I am seeking any information you have on how to take OTC sleep aids. You published an article quite a few years ago on the subject but I didn’t keep a copy of it so if you could cover the topic again, I would be grateful.
A: The National Sleep Foundation estimates that one fourth of all Americans take some form of sleep medication at some stage during the year. Common denominators for use include gender, age and level of education. Women are more likely to use aids than are men, older individuals and those with a higher level of education are more likely to seek OTC (over-the-counter) help. OTC sleep aids can be very effective short-term for the occasional night when a person has difficulties falling asleep and staying asleep; however, they are not meant to be taken on a regular basis. Most of the products available contain antihistamines that cause fatigue, nausea and other issues. And, the longer a person takes them, the less effective they become which translates into having to take them more frequently or in doses higher than recommended on the packaging. Further, some leave a person with a dry mouth, dizzy spells and feeling out of sorts the next day, as though they have a hangover from consuming too much alcohol. Also to be considered is the crossover effect from some medications, both OTC and prescription. So, let’s consider some of the more common choices on the market.
Melatonin is a natural hormone produced by the body’s pineal gland. This gland remains inactive during daylight but activates when darkness occurs, actively producing melatonin that is released into the blood. Melatonin is suppressed by daylight and the levels are low. They elevate at night. As a supplement, it is purported to help control a person’s natural sleep/wake cycle and has been recommended for individuals who travel frequently and suffer from jet lag. As I have stated previously, melatonin resets a person’s clock and appears to work effectively. It’s a good choice when taken according to packaging directions; however, it can cause the side effects of daytime sleepiness, headaches and even dizziness. Less common are anxiety, irritability and abdominal discomfort. Because supplemental melatonin is not considered a drug, it is not regulated by the FDA. The product is believed to help a person fall asleep faster and improve sleep but it will not modify the amount of sleep a person receives.
Benadryl, Unisom, and Sominex are amongst a group of sleep aids that contain the sedating antihistamine diphenhydramine. Memory impairment may occur; however, it is low on the list of side effects.
Valerian, a plant-based supplement, may reduce the time it takes a person to fall asleep and it may even provide better sleep overall; however, in addition to the standard side effects, valerian can cause abdominal discomfort, heart disturbances and a feeling of uneasiness.
Sleeping pills can interact with other medications so it is important to speak with your primary care physician to discuss the use of OTC sleep aids and determine if there are any potential crossover issues to be considered. If you get the go-ahead, pay close attention to the packaging directions on the brand you purchase. While there may be similarities, recommended doses will vary, so I cannot specifically tell you how to take them. Consider another view and try to get to the bottom of the reason for your poor sleep habits.
Readers who are interested in related information can order Dr. Gott’s Health Report “Sleep/Wake Disorders” by sending a self-addressed, stamped, number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
