Over-the-Counter Sleep Aids

Many people try an over-the-counter (OTC) sleep aid at one time or another. In fact, a 2018 Consumer Reports survey found that 1 in 3 people who had sleep problems at least once a week used OTC or prescription sleep aids.¹

These drugs and supplements may offer temporary help for a few sleepless nights. However, studies show that lifestyle changes work better for long-term (chronic) insomnia.^2,3

A few of the sleep aids and supplements you can buy without a prescription include:²

• Aleve^® PM (diphenhydramine hydrochloride, naproxen sodium)
• Benadryl^®, Dormin^®, Nytol^®, Simply Sleep^®, Sominex^® (diphenhydramine hydrochloride)
• Excedrin^® PM (acetaminophen, aspirin, diphenhydramine citrate)
• Melatonin
• Tylenol^® PM Extra Strength (acetaminophen, diphenhydramine hydrochloride)
• Unisom Sleeptabs^® (doxylamine succinate)
• Valerian root

Most OTC sleep aids are meant to be taken for a short time – no more than 2 weeks.²

Despite their popularity, studies show these products do little to treat insomnia.³

How do OTC sleep aids work?

Sleep aids with antihistamines like diphenhydramine or doxylamine succinate work by blocking certain chemicals in the brain to help you fall asleep. Most contain an antihistamine and can cause grogginess the next day. Some contain pain relievers, which can be helpful for people who cannot sleep because of pain. However, most OTC sleep aids contain an antihistamine and can cause grogginess the next day.^1-3

The melatonin that your body creates is a hormone. The kind you buy in a store is made in a factory. The amount of melatonin in supplements is higher than what your body produces naturally.³

Though melatonin is a popular supplement, it is not meant to treat insomnia. Instead, it is intended to help with jet lag. Some people may find melatonin to be helpful in the short term because it is sedating. But they have more success by changing their sleep habits and behaviors.⁴

There have been children hospitalized for an overdose of melatonin. An advisory was put out by the American Academy of Sleep Medicine to address this issue.⁴

What are the side effects of OTC sleep aids?

Many over-the-counter sleep aids contain the chemical diphenhydramine or doxylamine succinate. Both are sedative antihistamines, which means these drugs are used to fight allergies. When taken at night, these drugs can make you sleepy enough to fall asleep. Other side effects include a hungover feeling, daytime drowsiness, difficulty concentrating, dry mouth, constipation, and blurred vision.^2,3

There is another disadvantage to taking antihistamines as a sleep aid. You can quickly build up a tolerance to them. This means the longer you take it, the less likely it will make you sleepy.²

Melatonin can be helpful for jet lag or trouble falling asleep with short-term use. Side effects include headaches and daytime sleepiness. Valerian is not recommended for people with liver issues.^2,3

These are not all the possible side effects of over-the-counter sleep aids. Talk to your doctor about what to expect when taking over-the-counter sleep aids. You also should call your doctor if you have any changes that concern you when taking over-the-counter sleep aids.

What to know about OTC sleep aids?

In general, the benefits of sleeping pills are limited for most people. Only one-third of people in the Consumer Reports survey reported good sleep on the nights they took sleeping aids.¹

These drugs should not be taken while drinking alcohol. This is because these drugs may increase the effects of alcohol and potentially depress your system too much.^2,3

You should only take an OTC sleep aid if you have enough time to sleep for 8 hours. This helps give the drug time to work through your system.^2,3

Many OTC sleep aids should not be taken by people with these health conditions:^2,3

• Asthma
• Glaucoma
• Lung disease
• Sleep apnea
• Kidney disease
• Liver disease
• Some digestive issues
• Prostate problems

People who are pregnant or breastfeeding and people over age 75 should talk with their doctor before taking OTC sleep aids. Sleep aids carry extra risks for these groups.²

Over-the-counter sleep aids may be helpful for occasional use. However, improving sleep habits remains the best long-term solution for getting better sleep.²

Before beginning treatment for insomia, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.