Over-the-Counter Sleep Aids: Learn about OTC Sleep Medication

Sleep Aids: What You Need to Know

Bottles of prescription medications sit on the bedside table.
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The Food and Drug Administration (FDA) has approved over-the-counter (OTC) sleep medications to help relieve occasional sleeplessness in people ages 12 and older. Most OTC products sold as nighttime sleep aids contain an antihistamine, such as doxylamine (including brand names Nighttime Sleep Aid, Unisom Sleeptabs) or diphenhydramine (including brand names Benadryl, Compoz, Nytol and Sominex). Antihistamines are used to treat the symptoms of allergies; however, they cause drowsiness and are used to help people sleep.

There are dozens of sleep aid products available on the shelves of pharmacies and supermarkets. Some of these products also contain a pain medication or a cold and cough medication. Choosing the product most appropriate for you can be a challenge.

Before making a decision about which OTC preparation to use, talk to your healthcare provider or pharmacist, especially if you are taking other medications and are concerned about drug interactions. And once you purchase a sleep aid, make sure to read the label carefully. All OTC medications are required to list side effects and precautions for using the medication.

Common side effects of the antihistamines used in OTC sleep products are:

  • drowsiness the next day
  • dizziness
  • lack of coordination
  • reduced mental alertness
  • constipation
  • dry mouth and throat

Contact your healthcare provider if any of these side effects are severe, last for more than several days or give you blurred vision or difficulty urinating.

A Dr. Mike Tip for Older Adults: Use caution if you decide to use an OTC sleeping aid. Sleeping-pill use increases your risk of nighttime falls and injury, and in some older adults, diphenhydramine may have the opposite effect and make you agitated rather than sleepy!

OTC Sleep Medication Problems

In general, OTC sleep medications are most effective when you use them in moderation for a short period of time.

OTC sleep aids do not cure insomnia, and if used incorrectly, can cause a number of sleep and medication-related problems, which (depending on the medication you are using and for how long) may include:

Drug tolerance: You may develop tolerance to your medication, meaning that you need a higher dosage of the medication for it to work. With OTC sleep medications this can develop in less than a week. Taking more of the medication increases your risk for side effects.

Drug dependence: You may come to depend on your OTC medication to sleep and may not be able to sleep without it.

Side effects: As noted above, sleep medications can cause unwanted side effects. Generally, the most common side effect of the OTC sleep medications is drowsiness the next day, which can interfere with driving and working.

If you are drowsy or dizzy, do not drive, use machinery or do anything that requires you to be mentally alert.

Drug interactions: OTC sleeping medications can interact with other medications you are taking. These drug interactions can lead to dangerous side effects, especially when used with prescription painkillers, other sleep medications and medications used to treat mental health conditions.

Do not drink alcohol while taking OTC sleep medications as it can make the side effects much worse.

Rebound sleep problems: If you have been taking an OTC sleep medication for a long time and stop the medication, your sleep problem may become worse than before.

Using the medication for the wrong condition: You may have an underlying health condition that is causing you to be agitated or to experience sleeplessness. By using an OTC sleep medication, you may not be getting the treatment you need for your condition. For example, you may be suffering from depression, which can be treated with an antidepressant medication such as Zoloft (sertraline).

Tips for Better Sleep

If you are having trouble sleeping, these tips from the U.S. Food and Drug Administration (FDA) may be helpful:

  • Go to bed and get up at the same times each day.
  • Avoid caffeine, nicotine, beer, wine and liquor in the four to six hours before bedtime.
  • Don't exercise within two hours of bedtime.
  • Don't eat large meals within two hours of bedtime.
  • Don't nap later than 3 p.m.
  • Sleep in a dark, quiet room that isn't too hot or cold for you.
  • If you can't fall asleep within 20 minutes, get up and do something quiet.
  • Wind down in the 30 minutes before bedtime by doing something relaxing.

To learn more about your OTC sleep medication, including side effects and drug interactions with other medications and foods, use Drugs A to Z.

Insomnia. Diseases and Conditions Index. National Heart Lung and Blood Institute. August 13, 2008. http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.htm
Side Effects of Sleep Drugs. FDA Consumer Health Information. U.S. Food and Drug Administration. August 13, 2008. 

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