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Is it safe to take over-the-counter sleep medications?

Sometimes you do everything right—sleep and wake on a regular schedule, avoid caffeine and daytime naps, exercise regularly and avoid staring at blue-light screens too close to bedtime—and you still can’t sleep at night. Because over-the-counter (OTC) sleep aids are readily available, you might think taking them is safe. They can be, if used correctly. So, what should you know about these medications?

OTC sleep medications can help in the short term

It’s easy to assume that because you can buy something at the drugstore or grocery store, it’s all right to take it whenever you want. But over-the-counter sleep medications do come with some risks. These include:

  • Daytime grogginess, sometimes called “the hangover effect”

  • Dependency, where your body develops a tolerance and you need higher doses to get the same effect

  • Physical symptoms, such as blurred vision, confusion and constipation

  • Interactions with other medications

“Overall, I’m largely against the idea of individuals self-diagnosing sleep disorders and attempting OTC sleep aids on their own unless it’s a rare occurrence—them taking, for example, a Benadryl once in a great while that helps guarantee them a full night’s rest,” says Steven Hanrahan, D.O., a Piedmont family medicine specialist.

Which OTC sleep medication is right for you?

Different people react differently to medicine, and OTC sleep aids are no exception. With the various options available, it may take some time to find an option that works well for you—one that is approved by your physician. Here are the products that are easiest to find:

  • Diphenhydramine. Benadryl, Tylenol PM and other pain-relievers with a PM formulation contain diphenhydramine, which is a sedating antihistamine. While they can help you sleep if you have congestion or a cough, they may make you feel sleepy throughout the next day and cause dry mouth. “Antihistamines like Benadryl can occasionally cause psychosis or confusion that people 65-plus are more prone to experience,” adds Dr. Hanrahan.

  • Doxylamine succinate. Doxylamine succinate is sold as Unisom SleepTabs and is also a sedating antihistamine. Potential side effects include drowsiness the next day, dry mouth, blurred vision, constipation and urinary retention.

  • Melatonin. Your brain produces a hormone called melatonin, which helps control your natural sleep-wake cycle; the medication is a synthetic version. Research has found that taking OTC melatonin can be helpful with certain kinds of sleep problems, like jet lag, but there’s no clear evidence that it helps with general insomnia. “Melatonin can cause disturbance of the natural sleep-wake cycle if that is not the cause of [their] insomnia and additionally, I often see the supplement form come in a size of 10mg, which is quite a high dose compared with what I would typically recommend starting with,” says Dr. Hanrahan.

  • Valerian. Some supplements marketed as sleep aids include this plant. The good news is that it doesn’t appear to cause side effects. The bad news is most studies haven't found any benefits to taking it.

  • CBD/cannabidiol. The new kid on the block, CBD is on the list because some studies have found that CBD relieves anxiety, which may cause or contribute to insomnia and other sleep disorders. There is no conclusive data yet.

Sleep is an incredibly important part of our lives, and good sleep makes a huge difference in our daily function,” says Dr. Hanrahan.

So, if you find yourself reaching for the OTC sleep aids frequently, give your doctor a call.

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